Individual
LESLIE PHAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 LEGION DR, EASTMAN, GA 31023-6782
(478) 374-5571
Mailing address
662 GORDON RD, ROCHELLE, GA 31079-5547
(229) 938-5031
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002642
GA
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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