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General NPI Number Information
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NPI Number | 1669862769
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Entity Type | Organization
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Legal Business Name | WESTSIDE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/27/2015
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Provider Practice Location Address
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Address Line | 1695 MARIETTA BLVD NW AT ATLANTA BALLET
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City | ATLANTA
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State | GA
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Zip | 30318-3644
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Country | US
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Telephone | 404-382-8702
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Fax | 404-492-7034
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Provider Business Mailing Address
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Address Line | 2444 CLAIRMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-3330
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Country | US
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Telephone | 404-382-8702
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Fax | 404-492-7034
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN ARTHUR YEE
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Credential | PT
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Telephone | 404-441-0206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT008407
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License Number State | GA
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