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General NPI Number Information
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NPI Number | 1336239797
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY ASSOCIATES
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | RR 2 BOX 67AAA 351 PETE AVE
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City | WAYNESVILLE
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State | GA
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Zip | 31566-9714
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Country | US
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Telephone | 912-571-1556
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Fax | 734-319-6397
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | WAYNESVILLE
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State | GA
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Zip | 31566-0699
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Country | US
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Telephone | 912-571-1556
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Fax | 734-319-6397
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JOSEPH JOHN SEGUI JR.
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Credential | J.D.
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Telephone | 912-571-1556
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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 |
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License Number State |
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