Healthcare Provider Details

I. General information

NPI: 1912557935
Provider Name (Legal Business Name): CYGNI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 ROSELANE ST NW
MARIETTA GA
30060-7902
US

IV. Provider business mailing address

PO BOX 204
SMYRNA GA
30081-0204
US

V. Phone/Fax

Practice location:
  • Phone: 678-567-4710
  • Fax:
Mailing address:
  • Phone: 678-381-4128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALMIRA SMITH
Title or Position: OWNER/ PHYSICAL THERAPIST
Credential: PT
Phone: 678-381-4128