Individual
KIRSTEN BROOKE WAGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9420 WILLEO RD STE 202, ROSWELL, GA 30075-6773
(770) 594-7250
(770) 594-7251
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
(423) 238-7217
(423) 362-8684
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003671
GA
Other
Enumeration date
09/01/2016
Last updated
12/01/2017
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