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1356804611
KAYLA DANIELLE BROCK
LEESBURG, GA
NPI
1356804611
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: GA PTA003390)
Enumeration Date
2019-04-12
Last Update Date
2019-04-12
Business Address
KAYLA DANIELLE BROCK PTA
166 OAKLAND PKWY
LEESBURG, GA 31763-7200
Phone number: 229-495-6079
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Mailing Address
KAYLA DANIELLE BROCK PTA
166 OAKLAND PKWY
LEESBURG, GA 31763-7200
Phone number:
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