Mary Jincy Chackonal, MSPT
Physical Therapist in Lawrenceville, GA. Individual provider (NPI-1).
NPI number1124366349
StatusActive
Last updated in NPPESJan 23, 2013
Details
- NPI
- 1124366349
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mary Jincy Chackonal
- Credential
- MSPT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 23, 2013
- Last updated
- Jan 23, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT008253 | GA | Yes |
Practice location
3100 Club DrLawrenceville, GA 30044-2591
Phone 770-923-3100
Mailing address
3100 Club DrLawrenceville, GA 30044-2591
Phone 770-923-3100
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All 179 Physical Therapist providers in Lawrenceville · All 5,967 providers in Lawrenceville
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