Healthcare Provider Details

I. General information

NPI: 1699019968
Provider Name (Legal Business Name): JOSEPH K ARTHUR PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 CLIFTON RD NE
ATLANTA GA
30329-4021
US

IV. Provider business mailing address

934 JEFFERSON DR
ATLANTA GA
30350-7113
US

V. Phone/Fax

Practice location:
  • Phone: 404-728-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA002846
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: