Individual
MISS SHEENA ASHLEY WHITMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3615 BRASELTON HWY, DACULA, GA 30019-5906
(770) 904-0772
Mailing address
6225 IVY SPRINGS DR, FLOWERY BRANCH, GA 30542-5048
(770) 866-2911
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002704
GA
Other
Enumeration date
10/07/2010
Last updated
10/07/2010
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