Individual
JASON CARDILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
906 GRIER ST, WOODSTOCK, GA 30189-7811
(770) 402-4592
Mailing address
906 GRIER ST, WOODSTOCK, GA 30189-7811
(770) 402-4592
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004429
GA
Other
Enumeration date
04/16/2020
Last updated
04/16/2020
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