Individual
MR. JOSEPH LEE RICKETSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4274 N VALDOSTA RD, VALDOSTA, GA 31602-6814
(229) 241-9288
(229) 241-9443
Mailing address
5225 PAW PAW LN, LAKE PARK, GA 31636-3182
(229) 563-5085
(229) 890-3397
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013328
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT013328
PT BOARD
GA
Enumeration date
02/18/2008
Last updated
04/06/2018
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