Healthcare Provider Details

I. General information

NPI: 1972452860
Provider Name (Legal Business Name): EDUCATIONAL ADVANCEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2026
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 RIVERGLEN DR
LOGANVILLE GA
30052-9012
US

IV. Provider business mailing address

1520 RIVERGLEN DR
LOGANVILLE GA
30052-9012
US

V. Phone/Fax

Practice location:
  • Phone: 770-289-2302
  • Fax:
Mailing address:
  • Phone: 770-289-2302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GRETCHEN J TORBERT
Title or Position: FOUNDER AND CEO
Credential: PH.D.
Phone: 770-289-2302