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Organization

PHYSIO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID WILLIAM NEWSOME JR. DPT (PHYSICAL THERAPIST)
(336) 782-7461
Entity
Organization

Contact information

Practice address
3605 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4666
(770) 904-0772
Mailing address
3605 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4666

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
012019
GA

Other

Enumeration date
08/07/2015
Last updated
08/07/2015
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