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Individual

JENNIFER L STOCKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT,DPT

Contact information

Practice address
500 NATHAN DEAN BLVD STE 108, DALLAS, GA 30157-4912
(678) 402-7770
(678) 402-6947
Mailing address
2000 MIRROR LAKE BLVD STE S, VILLA RICA, GA 30180-2126
(770) 456-7877
(770) 456-7880

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012390
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003185761
GA
01
PT012390
PT LICENSE
GA
Enumeration date
06/20/2016
Last updated
09/14/2022
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