Individual
MADISON BAZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6884 HICKORY FLAT HWY, WOODSTOCK, GA 30188-3229
(770) 704-8244
Mailing address
6884 HICKORY FLAT HWY, WOODSTOCK, GA 30188-3229
(770) 704-8244
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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