Individual
STEPHEN WALLACE PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2040 COLONIAL DR, SAVANNAH, GA 31406-2226
(912) 354-2752
Mailing address
110 RICHMOND WALK DR, RICHMOND HILL, GA 31324-6921
(912) 321-7907
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003459
GA
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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