Individual
GEORGE WHITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4310 OREGON RD, SPRINGFIELD, TN 37172-6407
(310) 270-7453
Mailing address
4310 OREGON RD, SPRINGFIELD, TN 37172-6407
(310) 270-7453
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000004146
TN
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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