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General NPI Number Information
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NPI Number | 1023229101
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Entity Type | Individual
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Provider Name | OMANDA ALISHA HELTON PTA
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 386 BELAIRE DR
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City | HIAWASSEE
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State | GA
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Zip | 30546-3313
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Country | US
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Telephone | 706-896-2231
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Fax |
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Provider Business Mailing Address
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Address Line | 236 BRIDGEWATER DR
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City | MOUNT AIRY
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State | GA
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Zip | 30563-3661
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Country | US
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Telephone | 706-968-4047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA002357
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License Number State | GA
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