Healthcare Provider Details

I. General information

NPI: 1326247248
Provider Name (Legal Business Name): INTEGRATED THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 PEACHTREE RD NE STE D336
ATLANTA GA
30309-1148
US

IV. Provider business mailing address

2221 PEACHTREE RD NE STE D336
ATLANTA GA
30309-1148
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-5307
  • Fax: 404-351-5308
Mailing address:
  • Phone: 404-351-5307
  • Fax: 404-351-5308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number082388LG8
License Number StateGA

VIII. Authorized Official

Name: MS. HARRIET ADAMS
Title or Position: PRESIDENT
Credential:
Phone: 404-351-5307