Individual
CHARLENE D PORTEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2155 W PARK CT, SUITE G, STONE MOUNTAIN, GA 30087-3500
(770) 465-5084
(770) 465-5304
Mailing address
6040 CANAAN WOODS DR SW, ATLANTA, GA 30331-8052
(770) 465-5084
(770) 465-5304
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002099
GA
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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