Individual
JESSICA MASHAUN BIVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9390 THE LANDING DR, DOUGLASVILLE, GA 30135-7180
(770) 850-1692
Mailing address
916 MEADOWOOD LN, 0916, DOUGLASVILLE, GA 30135-8807
(321) 276-2353
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012558
GA
225100000X
Physical Therapist
PT30539
FL
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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