Individual
JERIKKA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
560 GRADY AVE STE C, FAYETTEVILLE, GA 30214-1975
(770) 461-6488
Mailing address
1311 BARBERRY LN, PEACHTREE CITY, GA 30269-6915
(706) 313-4734
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012200
GA
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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