MEDICARE: PEACHTREE PELVIC HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1144152182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACHTREE PELVIC HEALTH LLC

Provider Business Mailing Address
First Line	:	3294 ISLESWORTH TRCE
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-6289
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3294 ISLESWORTH TRCE
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30097-6289
Country	:	US
Telephone Number	:	404-394-5529
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DHRUTI PATEL
Credential	:	PT, DPT
Telephone Number	:	404-394-5529

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “PEACHTREE PELVIC HEALTH LLC ” Practice Location

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