MEDICARE: PEACH FIT PHYSICAL THERAPY & WELLNESS CENTER

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	:	1205552411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACH FIT PHYSICAL THERAPY & WELLNESS CENTER

Provider Business Mailing Address
First Line	:	2284 BELMONT CIR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-1539
Country	:	US
Telephone Number	:	423-618-3208
Fax Number	:

Provider Business Practice Location Address
First Line	:	2284 BELMONT CIR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-1539
Country	:	US
Telephone Number	:	423-618-3208
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. LAURA MARGARET GILES
Credential	:	DPT
Telephone Number	:	423-618-3208

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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