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General NPI Number Information
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NPI Number | 1124883830
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Entity Type | Individual
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Provider Name | MARCO SILVA DPT
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Gender | Male
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 2336 WISTERIA DR STE 420
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City | SNELLVILLE
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State | GA
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Zip | 30078-6160
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Country | US
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Telephone | 309-846-4878
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Fax |
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Provider Business Mailing Address
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Address Line | 2162 DEEP WOODS WAY
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City | MARIETTA
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State | GA
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Zip | 30062-2584
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Country | US
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Telephone | 404-889-0270
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Fax |
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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 | PT017017
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License Number State | GA
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