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Individual

TANGELA MCCORKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,ATC,LAT

Contact information

Practice address
4255 JOHNS CREEK PKWY, A, SUWANEE, GA 30024-6038
(770) 622-5344
Mailing address
4255 JOHNS CREEK PKWY, A, SUWANEE, GA 30024-6038
(770) 622-5344

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT001237
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AT001237
ATHLETIC TRAINER
GA
Enumeration date
03/14/2007
Last updated
07/08/2007
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