Most Relevant Information
Provider Data
| NPI Number: | 1003203720 |
| Provider Name: | PRISCILLA LAVALLEE KANE PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA002963 |
Most Important Dates
| Enumeration Date: | 04/21/2015 |
| Last Updated: | 04/21/2015 |
Provider Practice Location
6195 PATTINGHAM DR
ROSWELL
GA
300753969
Practice Location Phone/Fax
| Phone: | 7705870519 |
| Fax: |
Provider Mailing Location
6195 PATTINGHAM DR
ROSWELL
GA
300753969
Provider Mailing Phone/Fax
| Phone: | 7705870519 |
| Fax: |