Individual
LISA S DUCKWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3051 WATSON BLVD, WARNER ROBINS, GA 31093-8536
(478) 953-7556
(478) 953-4677
Mailing address
1060 JOHN E SULLIVAN RD, BYRON, GA 31008-5608
(478) 956-4205
(478) 956-4205
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1494
GA
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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