Individual
JENNIFER LAVALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1806 GRAND OAKS DR, WOODSTOCK, GA 30188-4800
(770) 361-8478
Mailing address
1806 GRAND OAKS DR, WOODSTOCK, GA 30188-4800
(770) 361-8478
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003794
GA
Other
Enumeration date
06/10/2015
Last updated
10/07/2023
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