Individual
MICAH R BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
400 TOWN PARK BLVD STE 100, EVANS, GA 30809-3471
(706) 854-9850
Mailing address
524 TELEGRAPH DR, AIKEN, SC 29801-5369
(803) 292-9343
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002425
GA
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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