Individual
BLAKE DARREN ALDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
401 PRESTON STREET, WAYCROSS, GA 31501
(912) 283-7342
(912) 283-7402
Mailing address
401 PRESTON ST, WAYCROSS, GA 31501-5248
(912) 283-7342
(912) 283-7402
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003749
GA
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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