Healthcare Provider Details

I. General information

NPI: 1568348647
Provider Name (Legal Business Name): ANDREW HUANG PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 PEACHTREE RD NE STE 110B
ATLANTA GA
30305-2430
US

IV. Provider business mailing address

3280 PEACHTREE RD NE STE 110B
ATLANTA GA
30305-2430
US

V. Phone/Fax

Practice location:
  • Phone: 404-382-8702
  • Fax:
Mailing address:
  • Phone: 404-382-8702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: