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General NPI Number Information
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NPI Number | 1225248552
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Entity Type | Individual
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Provider Name | SHERYL GRAHAM BEVERIDGE P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2155 POST OAK TRITT RD SUITE 400
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City | MARIETTA
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State | GA
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Zip | 30062-8620
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Country | US
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Telephone | 770-565-4044
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Fax | 770-565-5653
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Provider Business Mailing Address
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Address Line | 337 LANDS ML SE
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City | MARIETTA
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State | GA
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Zip | 30067-5178
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Country | US
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Telephone | 770-955-8737
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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 | PT001703
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License Number State | GA
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