Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT012111 | GA |
NPI | 1558738674 |
---|---|
Provider Name | Hannah Redd |
First Address | Atlanta, GA 30318-7512 |
Second Address | Atlanta, GA 30318-7512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2015 |
Last Update Date | 24/08/2015 |