Individual
DALE PIACENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2131 FOUNTAIN DR STE 201, SNELLVILLE, GA 30078-2969
(770) 972-1151
Mailing address
3060 MANOR CT, SNELLVILLE, GA 30078-2950
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3499
LICENSE#
GA
Enumeration date
05/16/2007
Last updated
07/08/2007
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