Healthcare Provider Details

I. General information

NPI: 1104995950
Provider Name (Legal Business Name): ANDREW JAMES MACFARLANE PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 PLEASANT HILL RD STE 1
DULUTH GA
30096-4807
US

IV. Provider business mailing address

3870 PLEASANT HILL RD STE 1
DULUTH GA
30096-4807
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-0743
  • Fax: 855-228-6169
Mailing address:
  • Phone: 404-355-0743
  • Fax: 855-228-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA000708
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: