Individual
JESSICA POWLEY REALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1505 JOHNSON FERRY RD STE 175, MARIETTA, GA 30062-9109
(770) 415-4815
Mailing address
1505 JOHNSON FERRY RD STE 175, MARIETTA, GA 30062-9109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6199
SC
Other
Enumeration date
07/14/2010
Last updated
12/28/2020
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