Individual
DEBORAH L. PREMENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
501 MITCHELL AVE, BOWDON, GA 30108-1407
(678) 890-9965
(678) 890-8750
Mailing address
501 MITCHELL AVE, BOWDON, GA 30108-1407
(678) 890-9965
(678) 890-8750
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000595
GA
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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