Individual
BRENTON STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2770 LENOX RD NE BLDG 1-02, ATLANTA, GA 30324-2860
(404) 364-9551
Mailing address
2770 LENOX RD NE BLDG 1-02, ATLANTA, GA 30324-2860
(404) 364-9551
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010269
GA
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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