SHANE MICHAEL ANTHONY

AUSTELL, GA
NPI1144501305
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: GA  PTA000604)
Enumeration Date2011-09-01
Last Update Date2011-09-09
Business Address
-- SHANE MICHAEL ANTHONY PTA
1025 E WEST CONNECTOR STE. 406
AUSTELL, GA 30106-8513
Phone number: 770-384-1001
Mailing Address
-- SHANE MICHAEL ANTHONY PTA
8823 PRODUCTION LN
OOLTEWAH, TN 37363-6511
Phone number: 423-238-7217
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