Individual
EBONY BELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5206 KENSINGTON CIR, LITHONIA, GA 30038-3242
(443) 695-2705
Mailing address
5206 KENSINGTON CIR, LITHONIA, GA 30038-3242
(443) 695-2705
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004851
GA
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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