Healthcare Provider Details

I. General information

NPI: 1013592989
Provider Name (Legal Business Name): PT SOLUTIONS OF ACWORTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1488 W WADE HAMPTON BLVD
GREER SC
29650-1167
US

IV. Provider business mailing address

PO BOX 96227
PHOENIX AZ
85072-6227
US

V. Phone/Fax

Practice location:
  • Phone: 864-469-0562
  • Fax: 864-469-0564
Mailing address:
  • Phone: 678-981-3543
  • Fax: 404-777-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: A'NNA GAYLORD
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 678-837-7176