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Individual

THEDA BURCHARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
130 MAIN ST, CLERMONT, GA 30527-1804
(678) 616-3099
Mailing address
2935 WESTWOOD TRL, GAINESVILLE, GA 30506-2889
(770) 539-2928

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001292
GA

Other

Enumeration date
10/17/2019
Last updated
10/17/2019
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