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General NPI Number Information
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NPI Number | 1194875500
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Entity Type | Organization
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Legal Business Name | A STEP AHEAD PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 930 WOODSTOCK RD SUITE 310
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City | ROSWELL
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State | GA
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Zip | 30075-2220
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Country | US
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Telephone | 770-998-6636
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Fax | 770-998-6646
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Provider Business Mailing Address
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Address Line | 930 WOODSTOCK RD SUITE 310
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City | ROSWELL
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State | GA
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Zip | 30075-2220
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Country | US
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Telephone | 770-998-6636
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Fax | 770-998-6646
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MR. BRAD S FREEMYER
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Credential | PT
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Telephone | 770-998-6636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT2661
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License Number State | GA
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