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General NPI Number Information
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NPI Number | 1588356893
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Entity Type | Individual
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Provider Name | HANNAH TILLEY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 3200 DOWNWOOD CIR NW STE 420
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City | ATLANTA
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State | GA
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Zip | 30327-1621
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Country | US
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Telephone | 404-352-4475
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Fax |
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Provider Business Mailing Address
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Address Line | 836 SAINT CHARLES AVE NE APT J
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City | ATLANTA
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State | GA
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Zip | 30306-4132
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Country | US
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Telephone | 843-801-4042
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT016562
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License Number State | GA
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