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Organization

MELINDA OSTROM

Active
Other names
GAME SUPPORT
Organization subpart
No

Provider details

NPI number
Authorized official
MELINDA OSTROM PT (OWNER, PT)
(404) 849-8235
Entity
Organization

Contact information

Practice address
1111 MORNINGSIDE PL NE, ATLANTA, GA 30306-3061
(404) 849-8235
Mailing address
1111 MORNINGSIDE PL NE, ATLANTA, GA 30306-3061
(404) 849-8235

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003108942B
GA
Enumeration date
01/09/2020
Last updated
05/19/2020
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