Individual
HALEY MERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2125 LOGANVILLE HWY STE 202, GRAYSON, GA 30017-1657
(678) 750-3330
Mailing address
5400 KENT ROCK RD, LOGANVILLE, GA 30052-4429
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT014152
PROFESSIONAL LICENSE
GA
Enumeration date
08/06/2019
Last updated
07/25/2022
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