Healthcare Provider Details

I. General information

NPI: 1053216143
Provider Name (Legal Business Name): KARLEE CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 JOHNS CREEK PKWY
SUWANEE GA
30024-6048
US

IV. Provider business mailing address

7570 GOLDEN SANDS DR
CUMMING GA
30041-2235
US

V. Phone/Fax

Practice location:
  • Phone: 770-692-0630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017319
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: