Individual
MISS MARLENE BRIONES GAMALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
840 PINE ST STE 880, MACON, GA 31201-7525
(478) 743-7092
Mailing address
214 W SPRING DR, MACON, GA 31220-6644
(478) 475-1015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003897
GA
Other
Enumeration date
02/15/2009
Last updated
02/15/2009
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