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Individual

ELEANOR KATHRYN STEVENBACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1230 JOHNSON FERRY PL STE G10, MARIETTA, GA 30068-2045
(770) 321-6705
(405) 551-3891
Mailing address
1230 JOHNSON FERRY PL STE G10, MARIETTA, GA 30068-2045
(770) 321-6705
(405) 551-3891

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015450
GA
225100000X
Physical Therapist
PT1015450
GA

Other

Enumeration date
08/09/2021
Last updated
08/27/2021
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