Individual
CAROL RICKABY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 OLD NORCROSS RD, SUITE 100, LAWRENCEVILLE, GA 30046-3389
(678) 377-2833
(678) 377-2882
Mailing address
5680 CLINCHFIELD TRL, NORCROSS, GA 30092-2052
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000869789B
—
GA
05
—
000869789C
—
GA
Enumeration date
09/25/2006
Last updated
09/24/2010
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