Joseph Lee Ricketson P.T.A.

NPI 1366610990 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1366610990
Gender Male
Enumeration Date 02/18/2008
Last Updated 02/18/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
4274 N VALDOSTA RD
VALDOSTA GA, 31602-6814, US
Phone (229) 241-9288
Fax (229) 241-9443
Business Location
610 BAYTREE RD
VALDOSTA GA, 31602-2811, US
Phone (229) 563-5085
Fax (229) 890-3397
Toxanomy
Taxonomy Code 225200000X
License State Georgia
License Number PTA002445
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According to our database, Mr. Joseph Lee Ricketson P.T.A. NPI is 1366610990, taxonomy code is 225200000X and license number is PTA002445, license state is located at Georgia. Joseph Lee Ricketson P.T.A. physically located at 4274 N Valdosta Rd, Valdosta GA, 31602-6814. NPI Number Joseph Lee Ricketson P.T.A. has the Individual type.

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1366610990 NPI number is provided on an as is basis without warranty of any kind. 1366610990 is maintained by the National Plan & Provider Enumeration System. The contents of Joseph Lee Ricketson P.T.A. are for informational purposes only.