Individual
CHRISTINE GAMACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
645 MOLLY LN, SUITE 100, WOODSTOCK, GA 30189-3756
(770) 517-1080
Mailing address
PO BOX 518, JONESBORO, GA 30237-0518
(770) 631-8277
(770) 631-9403
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004345
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT004345
STATE LISC. NUMBER
GA
Enumeration date
11/02/2006
Last updated
07/08/2007
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