Lydia Mikula Clackum, DPT Valid NPI

Individual provider · Physical Therapist · Loganville, GA

NPI

1295228781

Type

Individual (Type 1)

Primary specialty

Physical Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225100000X

License number

PT013374 (GA)

Sex

Female

Sole proprietor

No

Enumerated

2018-06-11

Last updated

2018-06-11