MEDICARE: JESSICA C. LONCAR 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	2251X0800X	Orthopedic Physical Therapist	PT006650	GA

General Provider Information

NPI Number	:	1750358867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA C. LONCAR PT

Provider Business Mailing Address
First Line	:	5975 ROSWELL RD STE C333
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4086
Country	:	US
Telephone Number	:	404-303-9153
Fax Number	:	404-303-9154

Provider Business Practice Location Address
First Line	:	5975 ROSWELL RD STE C333
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4086
Country	:	US
Telephone Number	:	404-303-9153
Fax Number	:	404-303-9154

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	01/30/2024

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