BEVERLY BLAKELY

FAYETTEVILLE, GA
NPI1417077116
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: GA  PT000628)
Enumeration Date2007-03-29
Last Update Date2007-07-08
Business Address
-- BEVERLY BLAKELY PT
1255 HIGHWAY 54 W
FAYETTEVILLE, GA 30214-4526
Phone number: 770-719-7182
Mailing Address
-- BEVERLY BLAKELY PT
12320 EDGEWATER DR
HAMPTON, GA 30228-2645
Phone number: 770-478-5131