Individual
NANCY EKSTROM TRIPHAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1551 JOHNSON FERRY RD, MARIETTA, GA 30062-6438
(770) 361-1772
Mailing address
1551 JOHNSON FERRY RD, MARIETTA, GA 30062-6438
(770) 361-1772
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002514
GA
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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