MEDICARE: FLUID LYMPHATICS AND THERAPY SERVICES COMPANY

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	261QP2000X	Physical Therapy Clinic/Center
2	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1972342723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLUID LYMPHATICS AND THERAPY SERVICES COMPANY

Provider Business Mailing Address
First Line	:	5681 SAVANNAH RIVER RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-5420
Country	:	US
Telephone Number	:	404-824-5798
Fax Number	:

Provider Business Practice Location Address
First Line	:	5681 SAVANNAH RIVER RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-5420
Country	:	US
Telephone Number	:	404-824-5798
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIELLE RIVERS
Credential	:
Telephone Number	:	404-824-5798

Provider Enumeration Date	:	05/21/2024
Last Update Date	:	11/10/2025

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