Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT005179 | GA |
N | 2251N0400X | Physical Therapist - Neurology | PT005179 | GA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT005179 | GA |
NPI | 1245441211 |
---|---|
Provider Name | Dr. Janet Bush Tankersley |
First Address | Appling, GA 30802-3604 |
Second Address | Augusta, GA 30912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |