Individual
MYRA BOERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1618 CLARK LAKE DR NW, ACWORTH, GA 30102-7906
(770) 794-8526
Mailing address
1618 CLARK LAKE DR NW, ACWORTH, GA 30102-7906
(770) 794-8526
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000310
GA
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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