Individual
ALISHA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-2903
(706) 721-5222
Mailing address
1120 15TH ST # OR-6000, AUGUSTA, GA 30912-0004
(706) 721-8623
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
6011
SC
225X00000X
Occupational Therapist
Primary
OT007903
GA
Other
Enumeration date
12/01/2020
Last updated
02/15/2023
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