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General NPI Number Information
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NPI Number | 1720423437
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Entity Type | Organization
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Legal Business Name | LESLIE K WOLFE DBA ATLANTA ORTHOTICS
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 1144 ZIMMER DR NE
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City | ATLANTA
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State | GA
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Zip | 30306-3321
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Country | US
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Telephone | 404-897-1205
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Fax |
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Provider Business Mailing Address
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Address Line | 1144 ZIMMER DR NE
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City | ATLANTA
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State | GA
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Zip | 30306-3321
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Country | US
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Telephone | 404-897-1205
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE WOLFE
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Credential | P.T.
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Telephone | 404-897-1205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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