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Individual

LARA E BETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1711 MARTHA BERRY BLVD NW, ROME, GA 30165-1623
(706) 528-4207
Mailing address
PO BOX 504, ROME, GA 30162-0504
(706) 291-1780
(706) 291-1782

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008282
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
700068640A
GA
05
700068640H
GA
01
P00359215
RR MEDICARE
GA
Enumeration date
06/22/2005
Last updated
01/02/2024
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