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General NPI Number Information
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NPI Number | 1811385669
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Entity Type | Organization
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Legal Business Name | NEWCARE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/02/2015
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 4350 PEACHTREE INDUSTRIAL BLVD STE 500E
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30071-1663
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Country | US
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Telephone | 770-595-2130
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Fax |
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Provider Business Mailing Address
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Address Line | 4350 PEACHTREE INDUSTRIAL BLVD STE 500E
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30071-1663
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Country | US
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Telephone | 770-595-2130
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MICHAEL Y SHIN
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Credential | D.P.T.
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Telephone | 770-595-2130
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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 | PT010087
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License Number State | GA
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