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General NPI Number Information
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NPI Number | 1346119831
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Entity Type | Organization
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Legal Business Name | EMORY PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 2745 DEKALB MEDICAL PKWY
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City | LITHONIA
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State | GA
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Zip | 30058-4931
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Country | US
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Telephone | 404-778-6390
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Fax |
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Provider Business Mailing Address
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Address Line | 8259 WICKER AVE
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City | SAINT JOHN
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State | IN
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Zip | 46373-8878
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Country | US
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Telephone | 740-275-4480
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | GREGORY L COOPER
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Credential |
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Telephone | 219-365-6560
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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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