Individual
FERNANDO SARMIENTO CUSTODIO V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 OAK GROVE CHURCH RD, CARROLLTON, GA 30117
(770) 834-1737
Mailing address
1235 NEW LAND DR, VIRGINIA BEACH, VA 23453-3120
(757) 574-2265
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604484
VA
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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