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Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
6505 SHILOH RD, SUITE 100, ALPHARETTA, GA 30005-8405
(678) 648-7644
Mailing address
6505 SHILOH RD, SUITE 100, ALPHARETTA, GA 30005-8405
(678) 648-7644

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012094
GA
2251P0200X
Pediatric Physical Therapist

Other

Enumeration date
08/20/2015
Last updated
02/05/2018
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