Individual
MRS. SUE ANN CLARK HEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6555 ABERCORN ST STE 221, SAVANNAH, GA 31405-5714
(912) 354-4474
(912) 354-4443
Mailing address
6555 ABERCORN ST STE 221, SAVANNAH, GA 31405-5714
(912) 354-4474
(912) 354-4443
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT002390
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00608704B
—
GA
01
—
PT002390
PT LICENSE
GA
Enumeration date
08/14/2006
Last updated
07/09/2007
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