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1285153833
LETITIA WISE
CARROLLTON, GA
NPI
1285153833
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: GA 001912)
Enumeration Date
2017-09-14
Last Update Date
2017-09-14
Business Address
LETITIA WISE PTA
2455 OAK GROVE CHURCH RD
CARROLLTON, GA 30117-9513
Phone number: 770-834-1737
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Mailing Address
LETITIA WISE PTA
PO BOX 5034
KINGSHILL, VI 00851-5034
Phone number: 340-473-1688
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