Individual
JESSICA CUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4024 LAWRENCEVILLE HWY NW STE 19, LILBURN, GA 30047-2805
(770) 931-8686
Mailing address
1454 W LAKE PL, GAINESVILLE, GA 30501-1554
(678) 294-0928
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014935
GA
2255A2300X
Athletic Trainer
AT002969
GA
Other
Enumeration date
10/12/2020
Last updated
11/04/2020
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