MEDICARE: MS. JANET POWE PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA002348	GA

General Provider Information

NPI Number	:	1073713681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET POWE PTA

Provider Business Mailing Address
First Line	:	PO BOX 2011
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533-0034
Country	:	US
Telephone Number	:	706-864-5237
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 MOUNTAIN DR
Second Line	:	REHAB
City	:	DAHLONEGA
State	:	GA
Zip	:	30533-1606
Country	:	US
Telephone Number	:	706-864-5237
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2007
Last Update Date	:	07/21/2007

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