Individual
JAN CARVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1451 NEWTON DR, TIFTON, GA 31794-3752
(229) 382-1665
Mailing address
34 JACKS WAY, TIFTON, GA 31793-6415
(229) 402-2059
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001663
GA
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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