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General NPI Number Information
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NPI Number | 1487453866
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Entity Type | Organization
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Legal Business Name | ATLAS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 4645 VILLAGE SQUARE DR STE A
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City | PADUCAH
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State | KY
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Zip | 42001-7448
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Country | US
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Telephone | 800-699-9395
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932184
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City | ATLANTA
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State | GA
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Zip | 31193-2184
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | AMANDA STREETER
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Credential |
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Telephone | 800-699-9395
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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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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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