Healthcare Provider Details

I. General information

NPI: 1669406070
Provider Name (Legal Business Name): PHYSICAL THERAPY ASSOCIATES OF CHATTANOOGA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12415 N MAIN STREET SUITE 1
TRENTON GA
30752-0942
US

IV. Provider business mailing address

PO BOX 942
TRENTON GA
30752-0942
US

V. Phone/Fax

Practice location:
  • Phone: 706-657-2700
  • Fax: 706-657-7965
Mailing address:
  • Phone: 706-657-2700
  • Fax: 706-657-7965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE BURTON REED III
Title or Position: OWNER SECRETARY
Credential: P.T.
Phone: 706-657-2700