Individual
GENNADY PILETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1990 VAUGHN RD NW, SUITE 330, KENNESAW, GA 30144-7098
(678) 403-3632
Mailing address
1990 VAUGHN RD NW, SUITE 330, KENNESAW, GA 30144-7098
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012613
GA
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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