Individual
STACIA DEAKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1901 W SCREVEN ST, QUITMAN, GA 31643-3913
(229) 263-6100
Mailing address
1901 W SCREVEN ST, QUITMAN, GA 31643-3913
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004009
GA
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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