Individual
ALEXIS VONTICE SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
129 GROVE LANDING CT, GROVETOWN, GA 30813-7002
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
3010
SC
224Z00000X
Occupational Therapy Assistant
Primary
OTA001333
GA
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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