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General NPI Number Information
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NPI Number | 1366364119
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Entity Type | Organization
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Legal Business Name | 416 PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 07/25/2026
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Last Update Date | 07/25/2026
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Provider Practice Location Address
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Address Line | 25 STATE ST
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City | COMMERCE
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State | GA
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Zip | 30529-1920
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Country | US
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Telephone | 706-968-0479
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Fax |
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Provider Business Mailing Address
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Address Line | 67 LIBERTY FREEDOM LN
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City | MAYSVILLE
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State | GA
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Zip | 30558-9812
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Country | US
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Telephone | 706-968-0479
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | DR. AUSTIN PEARSON
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Credential | DPT
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Telephone | 706-968-0479
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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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