Individual
NICOLE SUSAN GAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-1510
Mailing address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-1510
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A4812
NC
225200000X
Physical Therapy Assistant
Primary
PTA003246
GA
Other
Enumeration date
05/17/2013
Last updated
05/12/2026
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