Individual
DR. JACQUELINE VARNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, OCS, CSCS
Contact information
Practice address
120 OLIVE ST STE 300, AVONDALE ESTATES, GA 30002-1006
(678) 974-8594
(470) 437-3190
Mailing address
120 OLIVE ST STE 300, AVONDALE ESTATES, GA 30002-1006
(678) 974-8594
(470) 437-3190
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012353
GA
2251X0800X
Orthopedic Physical Therapist
PT012353
GA
Other
Enumeration date
12/01/2016
Last updated
01/14/2022
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