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Individual

BRIANNA WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
1400 HIGHWAY 76 E, HIAWASSEE, GA 30546-3960
(706) 374-4014
Mailing address
2765 MOBILE RD, MC CAYSVILLE, GA 30555-1832
(706) 455-0027

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004335
GA

Other

Enumeration date
03/01/2022
Last updated
08/22/2023
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