Healthcare Provider Details

I. General information

NPI: 1326529009
Provider Name (Legal Business Name): WILLIAM STEWART KREMER PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4272 WASHINGTON RD STE 3
EVANS GA
30809-3073
US

IV. Provider business mailing address

1100 CIRCLE 75 PKWY SE STE 1400
ATLANTA GA
30339-3067
US

V. Phone/Fax

Practice location:
  • Phone: 843-800-8345
  • Fax: 843-800-8346
Mailing address:
  • Phone: 678-981-3543
  • Fax: 404-777-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9422
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT013551
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: