Individual
LAURA SULLIVAN FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 PROFESSIONAL PKWY STE 220, WOODSTOCK, GA 30188-6444
(844) 543-8437
Mailing address
293 CREEKRIDGE CIR NW, ACWORTH, GA 30102-6903
(229) 328-5371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014284
GA
Other
Enumeration date
05/11/2021
Last updated
05/17/2021
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