Healthcare Provider Details

I. General information

NPI: 1902830144
Provider Name (Legal Business Name): OCONEE PHYSICAL THERAPY & SPORTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 MACON HWY
ATHENS GA
30606-5388
US

IV. Provider business mailing address

8081 MACON HWY
ATHENS GA
30606-5388
US

V. Phone/Fax

Practice location:
  • Phone: 706-769-6261
  • Fax: 706-762-6316
Mailing address:
  • Phone: 706-769-6261
  • Fax: 706-762-6316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateGA

VIII. Authorized Official

Name: BRITTANY SPAID MOON
Title or Position: PRESIDENT/CEO
Credential: PT, DPT, OCS
Phone: 912-682-6221