Individual
DEBORAH TAWIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT,NMT
Contact information
Practice address
118 BARRY ST, DECATUR, GA 30030-3465
(678) 592-0447
Mailing address
PO BOX 1748, PINE LAKE, GA 30072-1748
(678) 592-0447
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
005044
GA
225400000X
Rehabilitation Practitioner
Primary
005044
GA
Other
Enumeration date
07/16/2009
Last updated
08/15/2011
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