Healthcare Provider Details

I. General information

NPI: 1720298771
Provider Name (Legal Business Name): ROBIN JONES CRAIG PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 02/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TOWER RD NE SUITE 140
MARIETTA GA
30060-9411
US

IV. Provider business mailing address

8823 PRODUCTION LN
OOLTEWAH TN
37363-6511
US

V. Phone/Fax

Practice location:
  • Phone: 770-419-9437
  • Fax: 770-419-9443
Mailing address:
  • Phone: 423-238-7217
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2858
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: