Individual
WANDA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
150 ATHENS HWY, SUITE 600, LOGANVILLE, GA 30052-2277
(770) 554-2307
(770) 554-2309
Mailing address
3737 NINA CT, LOGANVILLE, GA 30052-5701
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002318
GA
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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