Individual
SUMMER NICOLE LOUGHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2403 BATTLEFIELD PKWY, FT OGLETHORPE, GA 30742-4033
(423) 595-4246
Mailing address
13530 HIGHWAY 151, TRION, GA 30753-1930
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000920
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTA000920
—
GA
Enumeration date
12/26/2018
Last updated
12/26/2018
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