Individual
JACOB MITCHELL KINCAID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
812 S PARK ST, CARROLLTON, GA 30117-4412
(770) 834-7436
Mailing address
120 E CENTER ST, CARROLLTON, GA 30117-3303
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016623
GA
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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