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General NPI Number Information
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NPI Number | 1801368378
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Entity Type | Organization
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Legal Business Name | THERAPY EXCELLENCE
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Dates
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Enumeration Date | 12/21/2018
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Last Update Date | 12/21/2018
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Provider Practice Location Address
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Address Line | 113 COMMONS WAY STE 402
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City | VILLA RICA
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State | GA
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Zip | 30180-7040
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Country | US
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Telephone | 770-459-6533
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Fax | 770-462-1260
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Provider Business Mailing Address
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Address Line | 2001 CHURCH LN
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City | VILLA RICA
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State | GA
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Zip | 30180-4720
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Country | US
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Telephone | 770-459-6533
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Fax | 770-462-1260
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KERRI S ESTES
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Credential |
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Telephone | 770-459-6533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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