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Individual

LUANNE MARIA MACISAAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
7130 MOUNT ZION BLVD STE 9, JONESBORO, GA 30236-2566
(770) 603-5660
(770) 603-6779
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915
(423) 238-7217
(423) 238-3473

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT013826
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT5430
LICENSE#
FL
Enumeration date
08/30/2006
Last updated
10/21/2019
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