Healthcare Provider Details

I. General information

NPI: 1043856479
Provider Name (Legal Business Name): ANNA TOMES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1882 CLAIRMONT RD
DECATUR GA
30033-3420
US

IV. Provider business mailing address

1882 CLAIRMONT RD
DECATUR GA
30033-3420
US

V. Phone/Fax

Practice location:
  • Phone: 404-664-1533
  • Fax:
Mailing address:
  • Phone: 404-664-1533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberOT007491
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: