Individual
LETISHA THARPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 BOSTICK CIR, MILLEDGEVILLE, GA 31061-3941
(478) 414-9600
Mailing address
300 SOMERSBY LN, MACON, GA 31210-7514
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007995
GA
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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