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Individual

MS. LILA FRAZER RALSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
104 MOORES GROVE RD, SUITE 100, WINTERVILLE, GA 30683-1506
(706) 742-0082
Mailing address
104 MOORES GROVE RD, SUITE 100, WINTERVILLE, GA 30683-1506
(706) 742-0082

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002401
GA

Other

Enumeration date
09/06/2007
Last updated
04/23/2008
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