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General NPI Number Information
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NPI Number | 1063715514
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Entity Type | Individual
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Provider Name | BETHANY LYNN NELSON PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 313 DIVIDEND DR STE 100313
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1949
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Country | US
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Telephone | 404-488-5342
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Fax | 470-264-7102
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Provider Business Mailing Address
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Address Line | 313 DIVIDEND DR STE 100
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1916
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Country | US
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Telephone | 404-488-5342
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Fax | 470-264-7102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 006835
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT006835
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License Number State | GA
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