Individual
MRS. AMY PRIDGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 ATKINSON RD, SUITE 1100, LAWRENCEVILLE, GA 30043-7986
(770) 995-2379
(770) 995-2385
Mailing address
1509 ATKINSON ROAD, SUITE 1100, LAWRENCEVILLE, GA 30043
(770) 995-2379
(770) 995-2385
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT006506
GA
2251P0200X
Pediatric Physical Therapist
Primary
PT006506
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000843554A
—
GA
05
—
0008436554A
—
GA
05
—
10037759
—
GA
05
—
306069
—
GA
Enumeration date
11/30/2006
Last updated
11/02/2010
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