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1154979193
LAMONT JOSEPH JACK
TUCKER, GA
NPI
1154979193
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: GA PTA002207)
Enumeration Date
2019-09-03
Last Update Date
2019-09-03
Business Address
LAMONT JOSEPH JACK PTA
3888 LAVISTA RD
TUCKER, GA 30084-5142
Phone number: 770-938-5740
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Mailing Address
LAMONT JOSEPH JACK PTA
3888 LAVISTA RD
TUCKER, GA 30084-5142
Phone number: 770-938-5740
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