Individual
KIRSTY L VANDERWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2336 DAWSON RD, ALBANY, GA 31707-2800
(229) 312-8700
Mailing address
500 W 3RD AVE, STE 101, ALBANY, GA 31701-1985
(229) 312-5800
(229) 312-5853
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007484
GA
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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