Individual
LUCY E HEAGY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
#1 MCGARITY ROAD, CANTON, GA 30115
(770) 360-9183
(770) 360-8965
Mailing address
3920 LOWER ROSWELL RD, MARIETTA, GA 30068-4058
(770) 265-5651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT000836
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035439
AMERIGROUP
GA
01
—
308944
WELLCARE
GA
Enumeration date
12/05/2006
Last updated
07/08/2007
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