Basic Information
| Provider Information | |||||||||
| NPI: | 1720393143 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VERLANDER | ||||||||
| FirstName: | MARY BETH | ||||||||
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| Credential: | M.P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 969 CREST VALLEY DR NW | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303274650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705003848 | ||||||||
| FaxNumber: | 6788681114 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 NORTHEAST EXPY NE | ||||||||
| Address2: | BUILDING 8, SUITE C | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303413932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705003848 | ||||||||
| FaxNumber: | 6788681114 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2010 | ||||||||
| LastUpdateDate: | 08/10/2010 | ||||||||
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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 | 225100000X | PT004001 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.