Individual
ANGELA BOSTIC-MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
494 LANCE VIEW LN, LAWRENCEVILLE, GA 30045-8719
(404) 273-2830
Mailing address
494 LANCE VIEW LN, LAWRENCEVILLE, GA 30045-8719
(404) 273-2830
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003660
GA
Other
Enumeration date
11/21/2019
Last updated
11/22/2019
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