Healthcare Provider Details

I. General information

NPI: 1770090441
Provider Name (Legal Business Name): PT SOLUTIONS HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 S HIGHWAY 25 W
WILLIAMSBURG KY
40769-1692
US

IV. Provider business mailing address

PO BOX 441146
KENNESAW GA
30160-9522
US

V. Phone/Fax

Practice location:
  • Phone: 606-539-7257
  • Fax: 606-549-4900
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARMEN PHILPOT
Title or Position: REVENUE DIRECTOR
Credential: P.T,D.P.T
Phone: 678-403-3568