Individual
TAMMY ANN LUPIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
805 SABLE TRACE HOLW, ACWORTH, GA 30102-7653
(678) 574-8003
Mailing address
805 SABLE TRACE HOLW, ACWORTH, GA 30102-7653
(678) 574-8003
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000619
GA
Other
Enumeration date
12/27/2010
Last updated
12/27/2010
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