Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT004317 | GA |
NPI | 1164647772 |
---|---|
Provider Name | George A Sitaras |
First Address | Suwanee, GA 30024-1361 |
Second Address | Gainesville, GA 30501-3715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |