Individual
MS. JANECE A RISTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
85 BROOKSTONE CRST, NEWNAN, GA 30265-3852
(770) 755-8768
Mailing address
85 BROOKSTONE CRST, NEWNAN, GA 30265-3852
(770) 755-8768
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002419
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT002419
PROFESSIONAL LICENSING STATE OF GEORGIA
GA
Enumeration date
05/05/2008
Last updated
07/10/2014
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