Individual
MALLORI CHASTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2470 DUG GAP RD, DALTON, GA 30720-9210
(706) 810-5980
Mailing address
199 WALLS RD, TUNNEL HILL, GA 30755-9802
(706) 483-5983
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003877
GA
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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