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Individual

ELIZABETH MORRIS MIDDLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420
Mailing address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 985-3420

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001333
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA001333
GA PTA LICENSE
GA
Enumeration date
02/28/2007
Last updated
07/08/2007
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