Individual
MARK ANDREW MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1500 OGLETHORPE AVE, BLDG 500, ATHENS, GA 30606-2179
(706) 549-9244
(706) 549-6102
Mailing address
PO BOX 6890, EVANSVILLE, IN 47719-0890
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001859
GA
Other
Enumeration date
12/09/2006
Last updated
07/08/2007
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