Individual
TERRI A DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3050 UNION CHURCH RD SW, STOCKBRIDGE, GA 30281-5430
(770) 378-0855
(770) 860-0120
Mailing address
3050 UNION CHURCH RD SW, STOCKBRIDGE, GA 30281-5430
(770) 378-0855
(770) 860-0120
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT006178
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10046652
AMERIGROUP
GA
Enumeration date
11/07/2006
Last updated
07/08/2007
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