Individual
FABIAN AZOFEIFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3206 PEACH ORCHARD RD, AUGUSTA, GA 30906-3540
(706) 798-9323
(706) 772-8873
Mailing address
PO BOX 5545, AUGUSTA, GA 30916-5545
(803) 349-4118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10775
SC
Other
Enumeration date
09/01/2020
Last updated
09/09/2025
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