Individual
JILL WHATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2109 N PATTERSON ST, STE A, VALDOSTA, GA 31602-2946
(229) 247-5225
Mailing address
5299 CYPRESS DR, LAKE PARK, GA 31636-3143
(229) 559-5819
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000952
GA
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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