Individual
MICHELLE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
155 1ST AVE, COCHRAN, GA 31014-5740
(478) 954-3711
(478) 954-3711
Mailing address
155 1ST AVE, COCHRAN, GA 31014-5740
(478) 954-3711
(478) 954-3711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT000395
GA
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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