Basic Information
| Provider Information | |||||||||
| NPI: | 1275931768 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMORY PHYSICAL THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 102831 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303682831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047786330 | ||||||||
| FaxNumber: | 4047786370 | ||||||||
| Practice Location | |||||||||
| Address1: | 6335 HOSPITAL PKWY STE 316 | ||||||||
| Address2: | |||||||||
| City: | JOHNS CREEK | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300975712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047786447 | ||||||||
| FaxNumber: | 6784731231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2014 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | COOPER | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 2193656560 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.