Individual
MEGAN E LANDRETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
348 BIG A RD, TOCCOA, GA 30577-6003
(770) 207-6390
Mailing address
348 BIG A RD, TOCCOA, GA 30577-6003
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008172
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT08172
PROFESSIONAL LICENSE
GA
Enumeration date
08/18/2021
Last updated
08/18/2021
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