Individual
KE PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3945 HOLCOMB BRIDGE RD STE 100, NORCROSS, GA 30092-5200
(770) 840-8045
Mailing address
3128 MERCER UNIVERSITY DR, ATLANTA, GA 30341-5630
(470) 439-8680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017445
GA
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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