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General NPI Number Information
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NPI Number | 1952920696
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Entity Type | Organization
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Legal Business Name | MICHELE POND PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 910 MARIETTA HWY STE 240
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City | ROSWELL
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State | GA
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Zip | 30075-6750
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Country | US
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Telephone | 773-551-1207
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Fax |
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Provider Business Mailing Address
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Address Line | 4429 DUNMORE RD NE
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City | MARIETTA
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State | GA
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Zip | 30068-4224
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Country | US
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Telephone | 773-551-1207
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MRS. MICHELE LYNN POND
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Credential | PT
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Telephone | 773-551-1207
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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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