Individual
JORDAN D MELLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1220 W WHEELER PKWY, AUGUSTA, GA 30909-6625
(706) 869-1515
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3071
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
AT001719
GA
Other
Enumeration date
07/05/2012
Last updated
06/10/2024
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