Individual
MR. WILLIS C JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3890 REDWINE RD SW, SUITE 114, ATLANTA, GA 30331-5582
(404) 344-7880
(404) 344-7881
Mailing address
3890 REDWINE RD SW, SUITE 114, ATLANTA, GA 30331-5582
(404) 344-7880
(404) 344-7881
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002223
GA
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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