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Individual

MRS. LAURICE DAWN REPKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
711 GREEN ST NW, GAINESVILLE, GA 30501-3374
(678) 936-7080
Mailing address
4167 CUMBERLAND POINT DR, GAINESVILLE, GA 30504-5351
(770) 297-1461

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 002429
GA

Other

Enumeration date
01/25/2011
Last updated
01/25/2011
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