Lamont Joseph Jack, PTA

NPI #1154979193 in Tucker, Georgia

Provider Information

NPI Number
1154979193
Entity Type
Individual
Name
Lamont Joseph Jack, PTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Therapy Assistant
Credential
PTA
Enumeration Date
Sep 3, 2019
Last Updated
Sep 3, 2019

Practice Location

Address
3888 LAVISTA RD
City
Tucker
State
Georgia
ZIP Code
30084-5142
Phone
(770) 938-5740

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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