WAYNE RICHARD DEFOREST

DALTON, GA
NPI1790911832
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: GA  OT002653)
Enumeration Date2009-06-03
Last Update Date2009-06-03
Business Address
-- WAYNE RICHARD DEFOREST OT
1013 RIVERBURCH PKWY SUITE 4
DALTON, GA 30721-8887
Phone number: 866-261-8090
Mailing Address
-- WAYNE RICHARD DEFOREST OT
1013 RIVERBURCH PKWY SUITE 4
DALTON, GA 30721-8887
Phone number: 866-261-8090