Individual
CASEY LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4450 FALCON PKWY, FLOWERY BRANCH, GA 30542-3176
(404) 778-6390
Mailing address
4450 FALCON PKWY, FLOWERY BRANCH, GA 30542-3176
(404) 778-6390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017151
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT017151
PT LICENSE
GA
Enumeration date
06/28/2024
Last updated
06/28/2024
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