Individual
JENNIFER RICHARDS BAZEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3139 MILFORD CHASE SW, MARIETTA, GA 30008-5786
(404) 788-3419
(770) 521-9210
Mailing address
3139 MILFORD CHASE SW, MARIETTA, GA 30008-5786
(404) 788-3419
(770) 521-9210
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006147
GA
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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