Healthcare Provider Details

I. General information

NPI: 1265195028
Provider Name (Legal Business Name): SOFIA GABRIELLA FERRARI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 MAIN ST W STE B
SNELLVILLE GA
30078-3156
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 470-719-1800
  • Fax: 470-719-1788
Mailing address:
  • Phone: 586-350-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015220
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: