=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326335027
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERICA LYNN SILVERMAN HOSKEN PT, DPT, OCS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2011
-----------------------------------------------------
Last Update Date | 06/17/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3400 MCCLURE BRIDGE RD, BLD D,STE A
-----------------------------------------------------
City | DULUTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30096-3009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-671-6114
-----------------------------------------------------
Fax | 855-655-5261
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2126 COUNCIL BLUFF CT NE
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30345-4130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-498-6529
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT010291
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------