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General NPI Number Information
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NPI Number | 1235954108
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Entity Type | Organization
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Legal Business Name | INVICTUS SMART PERFORMANCE, LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 04/06/2025
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Provider Practice Location Address
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Address Line | 1200 TOWN CENTER VILLAGE DR APT 1319
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City | MCDONOUGH
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State | GA
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Zip | 30253-5938
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Country | US
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Telephone | 479-799-0121
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Fax |
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Provider Business Mailing Address
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Address Line | 2086 JODECO RD # 1680
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City | MCDONOUGH
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State | GA
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Zip | 30253-5220
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Country | US
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Telephone | 678-827-2619
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. KAREN TAYLOR
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Credential | PT
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Telephone | 479-799-0121
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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 |
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License Number State |
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