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General NPI Number Information
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NPI Number | 1467586032
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Entity Type | Organization
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Legal Business Name | POTENTIAL PLUS
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 221 HAMILTON CROSSING RD NW
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City | CARTERSVILLE
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State | GA
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Zip | 30120-4814
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Country | US
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Telephone | 770-382-7248
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Fax | 770-382-3650
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Provider Business Mailing Address
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Address Line | 221 HAMILTON CROSSING RD NW
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City | CARTERSVILLE
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State | GA
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Zip | 30120-4814
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Country | US
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Telephone | 770-382-7248
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Fax | 770-382-3650
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | BARBARA MARVEL
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Credential | PT
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Telephone | 770-382-7248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT002558
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License Number State | GA
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