Individual
MR. CHARLES E MIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6849 PEACHTREE DUNWOODY RD NE STE 102, ATLANTA, GA 30328-1610
(678) 587-9922
Mailing address
10206 CAVALIER XING, LITHONIA, GA 30038-5363
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA000896
GA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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