Healthcare Provider Details

I. General information

NPI: 1114106010
Provider Name (Legal Business Name): MCPARS PHYSICAL THERAPY AND REHAB ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 MULKEY RD STE 101
AUSTELL GA
30106-1132
US

IV. Provider business mailing address

1810 MULKEY RD STE 101
AUSTELL GA
30106-1132
US

V. Phone/Fax

Practice location:
  • Phone: 770-443-4483
  • Fax: 770-443-4410
Mailing address:
  • Phone: 770-443-4483
  • Fax: 770-443-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT002574
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MONICA DAVIS
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 770-443-4483