Individual
JEDERA NWOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT, PT
Contact information
Practice address
5429 BOWMAN RD STE 140, MACON, GA 31210-8903
(478) 219-9673
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-21-154586
GA
225100000X
Physical Therapist
Primary
PT017500
GA
Other
Enumeration date
02/05/2021
Last updated
11/26/2024
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