Individual
GENTRY ELIZABETH BAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
150 MEDICAL WAY STE E1, RIVERDALE, GA 30274-2533
(770) 991-2747
(770) 991-1704
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011016
GA
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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