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General NPI Number Information
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NPI Number | 1508384074
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Entity Type | Individual
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Provider Name | JEANNE GRAF PT
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Gender | Female
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 3903 S COBB DR SE STE 275
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City | SMYRNA
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State | GA
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Zip | 30080-8504
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Country | US
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Telephone | 404-251-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 660 RALPH MCGILL BLVD NE APT 3321
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City | ATLANTA
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State | GA
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Zip | 30312-1161
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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 |
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT012873
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT012873
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License Number State | GA
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