Individual
SUSAN KEITH JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2001 CHURCH DR, VILLA RICA, GA 30180-4720
(770) 943-7979
(770) 943-7161
Mailing address
PO BOX 921, HIRAM, GA 30141-0921
(770) 943-7979
(770) 943-7161
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT008045
GA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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