Individual
LONNIE R. HERGOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1305 DANTIGNAC ST, AUGUSTA, GA 30901-2774
(706) 823-3807
(706) 823-3810
Mailing address
1305 DANTIGNAC ST, AUGUSTA, GA 30901-2774
(706) 823-3807
(706) 823-3810
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003346
GA
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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