Individual
REBECCA EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4660 RIVERSIDE PARK BLVD, MACON, GA 31210-1395
(478) 474-2114
Mailing address
301 BARRINGTON HALL DR, APT 209, MACON, GA 31220-0707
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002574
GA
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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