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General NPI Number Information
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NPI Number | 1760889869
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Entity Type | Organization
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Legal Business Name | ALLIANCE PHYSICAL THERAPY AND WELLNESS, LLC
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 10/07/2015
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Provider Practice Location Address
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Address Line | 14 HIGHBRANCH WAY
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City | NEWNAN
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State | GA
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Zip | 30265-6217
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Country | US
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Telephone | 954-303-4670
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Fax | 678-423-8819
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Provider Business Mailing Address
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Address Line | 14 HIGHBRANCH WAY
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City | NEWNAN
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State | GA
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Zip | 30265-6217
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Country | US
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Telephone | 954-303-4670
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Fax | 678-423-8819
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | PAULETTE LEWIS
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Credential | M.P.T., C.S.S.T.
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Telephone | 954-303-4670
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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 | PT008946
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License Number State | GA
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