Individual
ADAM DANIEL HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
791 OAK STREET, ATLANTA, GA 30354
(678) 539-5803
Mailing address
791 OAK STREET, ATLANTA, GA 30354
(678) 539-5803
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002498
GA
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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