Individual
HAYWARD WHITE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
315 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2500
(770) 991-2636
Mailing address
318 YOUNG JAMES CIR, STOCKBRIDGE, GA 30281-1469
(678) 887-6644
(678) 284-1699
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000054
GA
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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