Individual
LAURA MARIE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
142 RIDLEY LANE, DECATUR, GA 30030
(404) 406-7109
Mailing address
142 RIDLEY LN, DECATUR, GA 30030-2909
(404) 406-7109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007299
GA
Other
Enumeration date
05/16/2007
Last updated
08/08/2012
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