Individual
DR. KEN WHITLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
54 LUMPKIN CAMPGROUND RD S STE 100, DAWSONVILLE, GA 30534-6197
(706) 216-7910
Mailing address
5250 MILLSFORD CT, CUMMING, GA 30040-7478
(770) 889-3357
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004873
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000762187D
—
GA
Enumeration date
01/09/2007
Last updated
08/05/2010
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