Individual
AMANDA GUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3005 OLD ALABAMA RD, BUILDING E SUITE 10, JOHNS CREEK, GA 30022-8594
(770) 552-8852
Mailing address
4300 PACES FERRY RD SE, STE 478, ATLANTA, GA 30339-5790
(404) 479-1739
(404) 479-1739
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011553
GA
Other
Enumeration date
08/04/2014
Last updated
10/13/2016
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