Individual
DELROY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8099 REVERE DR, MCDONOUGH, GA 30252-8924
(404) 543-3823
Mailing address
8099 REVERE DR, MCDONOUGH, GA 30252-8924
(404) 543-3823
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
PTA001826
GA
Other
Enumeration date
03/03/2014
Last updated
03/03/2014
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