Individual
ELAINE MARROCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4163 RIVER MILL DR, DULUTH, GA 30097-2125
(541) 954-1013
Mailing address
4163 RIVER MILL DR, DULUTH, GA 30097-2125
(541) 954-1013
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
003325
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003325
GEORGIA STATE BOARD OF PHYSICAL THERAPY
GA
Enumeration date
10/17/2014
Last updated
10/17/2014
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