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General NPI Number Information
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NPI Number | 1023372596
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Entity Type | Organization
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Legal Business Name | AG ENTERPRISES ASSOCIATES, INC
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 2753 CONNALLY DR SW
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City | ATLANTA
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State | GA
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Zip | 30311-5509
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Country | US
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Telephone | 404-729-3736
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Fax |
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Provider Business Mailing Address
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Address Line | 2753 CONNALLY DR SW
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City | ATLANTA
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State | GA
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Zip | 30311-5509
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Country | US
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Telephone | 404-729-3736
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Fax | 404-344-3889
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. APRIL LEONARD
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Credential |
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Telephone | 404-729-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT010167
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License Number State | GA
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