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General NPI Number Information
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NPI Number | 1215141809
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Entity Type | Organization
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Legal Business Name | GAUDIO, INC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 7914 HWY 92 SUITE 100
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City | WOODSTOCK
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State | GA
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Zip | 30189
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Country | US
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Telephone | 770-924-3498
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Fax | 770-924-3692
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Provider Business Mailing Address
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Address Line | 7914 HWY 92 SUITE 100
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City | WOODSTOCK
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State | GA
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Zip | 30189
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Country | US
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Telephone | 770-924-3498
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Fax | 770-924-3692
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARIA GAUDIO
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Credential | PT
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Telephone | 770-924-3498
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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 | 002251
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License Number State | GA
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