Individual
LAURIE FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 JENNINGS MILL RD, WATKINSVILLE, GA 30677-7238
(706) 552-1949
Mailing address
1199 PRINCE AVE, ATHENS, GA 30606-2797
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
001566
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736059026A
—
GA
Enumeration date
12/18/2006
Last updated
02/18/2020
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