Individual
DR. NEIL JACOB HALTOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2336 WISTERIA DR STE 420, SNELLVILLE, GA 30078-6160
(404) 590-5366
(770) 982-0015
Mailing address
2336 WISTERIA DR STE 420, SNELLVILLE, GA 30078-6160
(404) 590-5366
(770) 982-0015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05013487A
IN
2251S0007X
Sports Physical Therapist
PT015162
GA
2251X0800X
Orthopedic Physical Therapist
Primary
PT015162
GA
Other
Enumeration date
08/20/2019
Last updated
03/04/2021
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