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General NPI Number Information
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NPI Number | 1407970072
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Entity Type | Organization
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Legal Business Name | UPWARD THERAPY, L.L.C.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 921 RICHMOND HILL DR
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City | MARIETTA
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State | GA
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Zip | 30068-4442
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Country | US
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Telephone | 770-265-2474
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Fax | 770-518-0331
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Provider Business Mailing Address
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Address Line | 921 RICHMOND HILL DR
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City | MARIETTA
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State | GA
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Zip | 30068-4442
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Country | US
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Telephone | 770-265-2474
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Fax | 770-518-0331
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KIMBERLY G. MILLER
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Credential | M.P.T.
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Telephone | 770-265-2474
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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 | 005376
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License Number State | GA
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