Basic Information
| Provider Information | |||||||||
| NPI: | 1124321666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUNNEY | ||||||||
| FirstName: | NIAMH | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2760 PRESTON RIDGE LN | ||||||||
| Address2: | |||||||||
| City: | DACULA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300193147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6785476172 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3001 MERCER UNIVERSITY DR | ||||||||
| Address2: | SUITE 106 DAVIS BUILDING | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303414115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6785476439 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2010 | ||||||||
| LastUpdateDate: | 12/06/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251N0400X | PT005829 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
No ID Information.