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Individual

KELLI BLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2300 LIAM AVE STE 104, DACULA, GA 30019-2265
(470) 294-0052
Mailing address
236 CANDLER WAY, WILLIAMSON, GA 30292-3284
(678) 577-3020

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016161
GA

Other

Enumeration date
08/19/2022
Last updated
08/26/2024
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