Individual
JAMES EDMUND SANTOS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
207 PEACHTREE ST, VILLA RICA, GA 30180-1821
(585) 820-8064
Mailing address
207 PEACHTREE ST, VILLA RICA, GA 30180-1821
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003525
GA
Other
Enumeration date
03/27/2020
Last updated
03/30/2020
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