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General NPI Number Information
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NPI Number | 1386941391
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Entity Type | Individual
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Provider Name | ARCHANA JAYAN BPT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 5245 BUFORD HWY STE 103/104
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City | NORCROSS
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State | GA
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Zip | 30071-2654
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Country | US
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Telephone | 770-449-5152
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Fax | 770-449-5154
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Provider Business Mailing Address
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Address Line | 5245 BUFORD HWY STE 103/104
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City | NORCROSS
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State | GA
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Zip | 30071-2654
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Country | US
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Telephone | 770-449-5152
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Fax | 770-449-5154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT010184
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License Number State | GA
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