LYDIA MIKULA CLACKUM

LOGANVILLE, GA
NPI1295228781
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: GA  PT013374)
Enumeration Date2018-06-11
Last Update Date2018-06-11
Business Address
LYDIA MIKULA CLACKUM DPT
3455 HIGHWAY 81 SOUTH
LOGANVILLE, GA 30052-3918
Phone number: 678-635-8280
Mailing Address
LYDIA MIKULA CLACKUM DPT
3455 HIGHWAY 81 SOUTH
LOGANVILLE, GA 30052-3918
Phone number: 770-554-0665
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