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Individual

LISA MARIE SHORT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
2350 LIMESTONE PKWY, GAINESVILLE, GA 30501-2087
(770) 534-5154
(770) 503-0183
Mailing address
PO BOX 908063, GAINESVILLE, GA 30501-0916
(770) 534-5154
(770) 503-0183

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003781
GA

Other

Enumeration date
03/31/2006
Last updated
07/08/2007
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