Individual
HUNTER REID SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 TOWN PARK BLVD, EVANS, GA 30809-3487
(706) 868-1707
Mailing address
2367 FRUIT HILL RD, NINETY SIX, SC 29666-5011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015755
GA
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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