Healthcare Provider Details

I. General information

NPI: 1528590940
Provider Name (Legal Business Name): ADDED PRESSURE MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1387 HAYNES MEADOW TRL
GRAYSON GA
30017-2816
US

IV. Provider business mailing address

1387 HAYNES MEADOW TRL
GRAYSON GA
30017-2816
US

V. Phone/Fax

Practice location:
  • Phone: 404-307-8201
  • Fax:
Mailing address:
  • Phone: 404-307-8201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA002167
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT000813
License Number StateGA

VIII. Authorized Official

Name: JAMES ELLIOTT BECKETT
Title or Position: OWNER/OPERATOR
Credential: LMT, LPTA
Phone: 404-307-8201