Individual
JOHN T BASSETT V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2000 MIRROR LAKE BLVD, SUITE S, VILLA RICA, GA 30180-2124
(770) 456-7877
(706) 456-7880
Mailing address
2000 MIRROR LAKE BLVD, SUITE S, VILLA RICA, GA 30180-2124
(770) 456-7877
(706) 456-7880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009823
GA
Other
Enumeration date
11/23/2009
Last updated
11/23/2009
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