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General NPI Number Information
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NPI Number | 1740748045
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Entity Type | Organization
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Legal Business Name | INTEGRATE2 PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 110 EVANS MILL DR STE 206
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City | DALLAS
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State | GA
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Zip | 30157-1624
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Country | US
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Telephone | 678-909-9278
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Fax | 833-264-6634
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Provider Business Mailing Address
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Address Line | 110 EVANS MILL DR STE 206
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City | DALLAS
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State | GA
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Zip | 30157-1624
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Country | US
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Telephone | 678-909-9278
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Fax | 833-264-6634
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. ELLEN PARKER
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Credential | P. T.
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Telephone | 678-909-9278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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