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Individual

MRS. MARIE SHERWINE ALTIDOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
6849 PEACHTREE DUNWOODY RD NE, BLDG B-1 SUITE 102, ATLANTA, GA 30328-1610
(866) 587-9922
(678) 587-9993
Mailing address
237 HICKORY BRANCH DR, ACWORTH, GA 30101-8773
(678) 574-9071

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002226
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA002226
PHYSICAL THERAPIST ASSIST
GA
Enumeration date
05/14/2007
Last updated
07/08/2007
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