Individual
DEWIGHT CARRUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1624 LEXINGTON CIR, VALDOSTA, GA 31602-5700
(706) 536-7664
Mailing address
1624 LEXINGTON CIR, VALDOSTA, GA 31602-5700
(706) 536-7664
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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