Healthcare Provider Details

I. General information

NPI: 1225367030
Provider Name (Legal Business Name): FRANCISCO B CUARESMA JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRANCISCO B CUARESMA JR. PT

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 RIVERBURCH PKWY SUITE 4
DALTON GA
30721-8887
US

IV. Provider business mailing address

1013 RIVERBURCH PARKWAY SUITE 4
DALTON GA
30721-8887
US

V. Phone/Fax

Practice location:
  • Phone: 866-261-8090
  • Fax:
Mailing address:
  • Phone: 866-261-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT009616
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: