Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT001565 | GA |
NPI | 1124107677 |
---|---|
Provider Name | Mrs. Linda D Schultheiss |
First Address | Duluth, GA 30097-1794 |
Second Address | Suwanee, GA 30024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |