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KELLY MACKENZIE SAMS PTA

>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1023593217

Individual Registrant:
 KELLY MACKENZIE SAMS PTA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
144 DEPOT ST  BUCHANAN, GA 30113-5216 US
Tel: 770-646-5512  Fax: --

Contact information for business:
52 CEDAR CREEK DR  DALLAS, GA 30157-6609 US
Tel: --  Fax: --

Registration Information:
NPI: 1023593217
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225200000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapy Assistant
GAPTA003946

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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