Individual
BRENNA JILL STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3114 COBB PKWY NW, KENNESAW, GA 30152-1017
(770) 377-2927
Mailing address
6168 WINDFLOWER DR, POWDER SPRINGS, GA 30127-8321
(770) 377-2927
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009395
GA
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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