Individual
JORDAN WISENBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
331 COMMERCE DR, PEACHTREE CITY, GA 30269-3516
(770) 631-0400
Mailing address
331 COMMERCE DR, PEACHTREE CITY, GA 30269-3516
(770) 631-0400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017135
GA
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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