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General NPI Number Information
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NPI Number | 1619037165
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Entity Type | Organization
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Legal Business Name | CROSS MY HEART PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1260 HIGHWAY 54 W SUITE 101
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4514
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Country | US
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Telephone | 404-392-7110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 877
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City | SHARPSBURG
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State | GA
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Zip | 30277-0877
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Country | US
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Telephone | 404-392-7110
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MRS. KAREN BARBER
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Credential |
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Telephone | 404-392-7110
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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 | 4808
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License Number State | GA
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