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Individual

MRS. ELIZABETH THOMPSON DANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2601A DEMERE RD, ST SIMONS ISLAND, GA 31522-1614
(912) 634-9945
(912) 638-1584
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 236-2774
(706) 236-2783

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001496
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
589630550A
GA
Enumeration date
10/13/2006
Last updated
03/19/2014
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