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General NPI Number Information
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NPI Number | 1972100865
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Entity Type | Organization
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Legal Business Name | RESILIENT PHYSIO, LLC
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 790 WEST AVE
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3402
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Country | US
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Telephone | 608-778-4499
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Fax |
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Provider Business Mailing Address
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Address Line | 19 COLLEEN KAREN RD SW
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City | EUHARLEE
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State | GA
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Zip | 30120-6006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | EMILY RAND
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Credential | PT, DPT
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Telephone | 608-778-4499
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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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