Healthcare Provider Details

I. General information

NPI: 1548949969
Provider Name (Legal Business Name): LYMBER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 HIGHWAY 138 SW
RIVERDALE GA
30296-1881
US

IV. Provider business mailing address

160 MORNING SPRINGS WALK
FAYETTEVILLE GA
30214-2660
US

V. Phone/Fax

Practice location:
  • Phone: 678-586-5937
  • Fax: 678-586-5938
Mailing address:
  • Phone: 770-896-5173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHAKA SAUNDERS
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 770-896-5173