NPI 1255063616

Sierra Elexus Mercedes Cornelous

Practitioner Physical Therapy Assistant Lawrenceville, GA

Practice location

Address: 1404 Lawrenceville Suwanee Rd, Lawrenceville, GA 30043-4331
Phone: (678) 646-1280
Mailing address: 1404 Lawrenceville Suwanee Rd STE 101, Lawrenceville, GA 30043

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 004886 (GA)

Other Physical Therapy Assistant providers in Georgia →

Registry record

NPI: 1255063616
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Jun 2022
Record last updated: 25 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.