Individual
MR. LEE HAWKINS GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
4523 FORSYTH RD, MACON, GA 31210-4527
(478) 254-7010
(478) 254-7012
Mailing address
4523 FORSYTH RD, MACON, GA 31210-4527
(478) 254-7010
(478) 254-7012
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002501
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA002501
GEORGIA STATE LICENSE
GA
Enumeration date
01/30/2011
Last updated
01/30/2011
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