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Individual

JEFFREY B GIDDENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1711 MARTHA BERRY BLVD NW, ROME, GA 30165-1623
(706) 528-4207
Mailing address
PO BOX 528, ROME, GA 30162-0528
(706) 638-3880
(706) 638-3890

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006659
GA
225100000X
Physical Therapist
PTH5116
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000904648K
GA
01
P00853195
RR MEDICARE
GA
Enumeration date
06/22/2005
Last updated
12/15/2022
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