Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA003381 | GA |
NPI | 1013308923 |
---|---|
Provider Name | Mrs. Sarah Winter |
First Address | Marietta, GA 30067-4440 |
Second Address | Marietta, GA 30067-4440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2015 |
Last Update Date | 13/02/2015 |