Individual
VIVIAN ALBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
545 OLD NORCROSS RD STE 100, LAWRENCEVILLE, GA 30046-3390
(678) 377-2833
Mailing address
545 OLD NORCROSS RD STE 100, LAWRENCEVILLE, GA 30046-3390
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT012551
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT012551
LICENSE NUMBER
GA
Enumeration date
08/11/2016
Last updated
08/11/2016
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