Individual
JOYCE NIBATEN BALAWON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2130 ANDERSON MILL RD, AUSTELL, GA 30106-1806
(770) 941-8813
Mailing address
2130 ANDERSON MILL RD, AUSTELL, GA 30106-1806
(770) 941-8813
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003588
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003588
GEORGIA STATE BOARD OF PHYSICAL THERAPY
GA
01
—
057816618
GEORGIA DEPARTMENT OF DRIVERS SERVICES
GA
Enumeration date
09/20/2018
Last updated
09/20/2018
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