Healthcare Provider Details

I. General information

NPI: 1144152182
Provider Name (Legal Business Name): PEACHTREE PELVIC HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3294 ISLESWORTH TRCE
DULUTH GA
30097-6289
US

IV. Provider business mailing address

3294 ISLESWORTH TRCE
DULUTH GA
30097-6289
US

V. Phone/Fax

Practice location:
  • Phone: 404-394-5529
  • Fax:
Mailing address:
  • Phone:
  • 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: DHRUTI PATEL
Title or Position: OWNER
Credential: PT, DPT
Phone: 404-394-5529