Healthcare Provider Details

I. General information

NPI: 1104738830
Provider Name (Legal Business Name): MICHAEL HINERTH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3355 CASCADE RD SW
ATLANTA GA
30311-3678
US

IV. Provider business mailing address

2934 BOULDER WALK CT SE
ATLANTA GA
30316-3992
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-4151
  • Fax:
Mailing address:
  • Phone: 850-748-2456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011881
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: