MEDICARE: SHARI BERMAN PTA

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	225200000X	Physical Therapy Assistant	PTA000232	GA

General Provider Information

NPI Number	:	1346430071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI BERMAN PTA

Provider Business Mailing Address
First Line	:	1835 SAVOY DR
Second Line	:	SUITE 100
City	:	ATLANTA
State	:	GA
Zip	:	30341-1072
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:	866-857-8655

Provider Business Practice Location Address
First Line	:	1835 SAVOY DR
Second Line	:	SUITE 100
City	:	ATLANTA
State	:	GA
Zip	:	30341-1072
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:	866-857-8655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	03/07/2013

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