Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA000879 | GA |
NPI | 1013240225 |
---|---|
Provider Name | Ioan Marius Stalinescu |
First Address | Lawrenceville, GA 30043-8017 |
Second Address | Lawrenceville, GA 30043-8017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2009 |
Last Update Date | 08/09/2009 |