Individual
GREGORY C IZENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1483 SPRINGLEAF CIR SE, SMYRNA, GA 30080-2403
(404) 510-2927
Mailing address
1483 SPRINGLEAF CIR SE, SMYRNA, GA 30080-2403
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004519
GA
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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