MEDICARE: JOHN DAVID BOVE PT

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	PT7925	GA

General Provider Information

NPI Number	:	1437344322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN DAVID BOVE PT

Provider Business Mailing Address
First Line	:	4411 SUWANEE DAM RD
Second Line	:	SUITE 330
City	:	SUWANEE
State	:	GA
Zip	:	30024-8701
Country	:	US
Telephone Number	:	770-904-2332
Fax Number	:	770-904-2395

Provider Business Practice Location Address
First Line	:	4411 SUWANEE DAM RD
Second Line	:	SUITE 330
City	:	SUWANEE
State	:	GA
Zip	:	30024-8701
Country	:	US
Telephone Number	:	770-904-2332
Fax Number	:	770-904-2395

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

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	03/02/2011

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Directions to “ JOHN DAVID BOVE PT” Practice Location

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