Healthcare Provider Details

I. General information

NPI: 1255728325
Provider Name (Legal Business Name): AVERY PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 NE 1ST AVE
HIGH SPRINGS FL
32643-9443
US

IV. Provider business mailing address

1455 OLD ALABAMA RD STE 160
ROSWELL GA
30076-2129
US

V. Phone/Fax

Practice location:
  • Phone: 386-454-0533
  • Fax:
Mailing address:
  • Phone: 770-642-6100
  • Fax: 678-367-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF MOORE
Title or Position: CEO
Credential:
Phone: 770-639-5809