Individual
JOSEPH POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 LAWRENCEVILLE ST STE 103, MCDONOUGH, GA 30253-2351
(770) 898-5401
Mailing address
4522 WESTMINSTER DR, ELLENWOOD, GA 30294-3795
(678) 565-8164
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007482
LICENSE#
GA
Enumeration date
11/07/2006
Last updated
07/08/2007
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