Individual
JUSTIN SPEARS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2037 MESA DR SE, ATLANTA, GA 30316-4915
(404) 713-9382
Mailing address
2037 MESA DR SE, ATLANTA, GA 30316-4915
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
225800000X
Recreation Therapist
—
—
Other
Enumeration date
12/15/2012
Last updated
12/15/2012
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