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General NPI Number Information
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NPI Number | 1972750503
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Entity Type | Organization
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Legal Business Name | ABOVE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 4411 SUWANEE DAM RD SUITE #330
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City | SUWANEE
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State | GA
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Zip | 30024-8701
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Country | US
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Telephone | 770-904-2332
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 SUWANEE DAM RD SUITE #330
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City | SUWANEE
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State | GA
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Zip | 30024-8701
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Country | US
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Telephone | 770-904-2332
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA-ELENA BOVE
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Credential | MSPT
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Telephone | 770-904-2332
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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 | PT006440
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License Number State | GA
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