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General NPI Number Information
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NPI Number | 1548448731
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Entity Type | Organization
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Legal Business Name | NEUROMUSCULAR ORTHOPEDICS
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Dates
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Enumeration Date | 02/10/2008
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Last Update Date | 06/22/2008
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Provider Practice Location Address
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Address Line | 275 CARPENTER DR NE SUITE 307
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City | ATLANTA
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State | GA
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Zip | 30328-4928
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Country | US
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Telephone | 404-943-1053
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Fax |
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Provider Business Mailing Address
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Address Line | 4911 HERITAGE TRACE CT
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City | MARIETTA
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State | GA
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Zip | 30062-6309
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Country | US
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Telephone | 678-795-9835
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER/THERAPIST
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Name | MS. SUSAN HUBENY
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Credential |
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Telephone | 404-943-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT004390
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 226300000X
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Taxonomy Name | Kinesiotherapist
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License Number | MT004390
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MT004390
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License Number State | GA
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