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Individual

LISA A DUCKWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
103 MAPLE DR, SUITE 8, MARTINEZ, GA 30907-4283
(706) 364-5262
(706) 364-5263
Mailing address
410 UNIVERSITY PKWY, STE 100, AIKEN, SC 29801-6810
(803) 293-1540

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT04118
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000767456C
GA
Enumeration date
11/13/2006
Last updated
11/11/2021
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