MEDICARE: JOSEPH MELVIN SAPP 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	4656	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922020361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MELVIN SAPP PT

Provider Business Mailing Address
First Line	:	2 MASHBURN ST 102
Second Line	:
City	:	HAWKINSVILLE
State	:	GA
Zip	:	31036-4961
Country	:	US
Telephone Number	:	478-783-4460
Fax Number	:	478-783-4466

Provider Business Practice Location Address
First Line	:	3051 WATSON BLVD 525
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-8556
Country	:	US
Telephone Number	:	478-953-4563
Fax Number	:	478-953-4564

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/22/2015

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