Individual
KERI SUNVOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1255 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4526
(770) 719-7256
Mailing address
15 WILLOUGHBY RUN, SHARPSBURG, GA 30277-2250
(770) 841-8343
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005789
GA
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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