Organization
GEORGIA SPORTS THERAPY AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER JAMES MALLARE M.S., P.T. (CLINICAL DIRECTOR)
(770) 932-3212
Entity
Organization
Contact information
Practice address
3511 BRASELTON HWY, STE G-2, DACULA, GA 30019-5925
(770) 932-3212
(770) 932-3577
Mailing address
3511 BRASELTON HWY, STE G-2, DACULA, GA 30019-5925
(770) 932-3212
(770) 932-3577
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4122
GA
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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