Healthcare Provider Details

I. General information

NPI: 1144696964
Provider Name (Legal Business Name): BRITTANY ALDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2015
Last Update Date: 08/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 HOWELL FERRY RD
DULUTH GA
30096-3178
US

IV. Provider business mailing address

3450 BLAIR CIR NE UNIT 1206
BROOKHAVEN GA
30319-2241
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-6800
  • Fax:
Mailing address:
  • Phone: 678-333-6803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number012062
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: