Individual
JARRETT EVAN MASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1240 HIGHWAY 54 W STE 404, FAYETTEVILLE, GA 30214-4564
(470) 615-0485
Mailing address
PO BOX 362, GAY, GA 30218-0362
(770) 880-9288
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016640
GA
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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