Individual
AUBIE BLAKE MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5610 HAMPTON PARK DR, CUMMING, GA 30041-4004
(678) 965-5700
Mailing address
2131 LUMPKIN CAMPGROUND RD S, DAWSONVILLE, GA 30534-7159
(706) 531-4769
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004049
GA
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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