Individual
MRS. CAROL GIBBS CROCHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2675 N DECATUR RD, STE 105, DECATUR, GA 30033-6131
(404) 501-7646
Mailing address
680 SUZANNE DR, DECATUR, GA 30033-5506
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004433
GA
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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