Individual
MARIE SCHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
560 GRADY AVE STE C, FAYETTEVILLE, GA 30214-1975
(770) 461-6488
Mailing address
310 WYNGATE CIR, FAYETTEVILLE, GA 30215-2433
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3383
LICENSE#
GA
Enumeration date
07/12/2007
Last updated
07/12/2007
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