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General NPI Number Information
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NPI Number | 1316356066
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Entity Type | Organization
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Legal Business Name | EMORY UNIVERSITY
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1462 CLIFTON RD NE SUITE 312
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City | ATLANTA
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State | GA
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Zip | 30322-1000
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Country | US
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Telephone | 404-712-5660
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Fax |
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Provider Business Mailing Address
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Address Line | 3443 KINGSBORO RD NE APARTMENT 1115
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City | ATLANTA
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State | GA
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Zip | 30326-3316
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Country | US
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Telephone | 678-612-8264
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Fax |
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Authorized Official
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Title or Position | RESIDENT DIRECTOR
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Name | DR. LAURA ZAJAC-COX
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Credential | PT, DPT, NCS
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Telephone | 404-712-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PT011587
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License Number State | GA
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