Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT005829 | GA |
NPI | 1124321666 |
---|---|
Provider Name | Niamh Tunney |
First Address | Dacula, GA 30019-3147 |
Second Address | Atlanta, GA 30341-4115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2010 |
Last Update Date | 06/12/2010 |