Basic Information
| Provider Information | |||||||||
| NPI: | 1538340385 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSIOTHERAPY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1720 PEACHTREE ST NW | ||||||||
| Address2: | SUIT 422 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303092449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047331936 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1720 PEACHTREE ST NW | ||||||||
| Address2: | SUIT 422 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303092449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047331936 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2007 | ||||||||
| LastUpdateDate: | 11/21/2007 | ||||||||
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| AuthorizedOfficialLastName: | FITZPATRICK | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6106447824 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT008691 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.