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NPI Code Detail

MEDICARE: SIERRA THERAPY SERVICES, INC.

MEDICARE: SIERRA THERAPY SERVICES, INC.
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
1225100000XPhysical TherapistPT004347GA

General Provider Information

NPI Number : 1083643449
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIERRA THERAPY SERVICES, INC.
Provider Business Mailing Address
First Line : 2155 WEST PARK COURT
Second Line : SUITE G/ H
City : STONE MOUNTAIN
State : GA
Zip : 30087
Country : US
Telephone Number : 770-465-5084
Fax Number : 770-465-5304
Provider Business Practice Location Address
First Line : 2155 W PARK CT
Second Line : SUITE G/ H
City : STONE MOUNTAIN
State : GA
Zip : 30087-3500
Country : US
Telephone Number : 770-465-5084
Fax Number : 770-465-5304
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. QUEENSTON U THORPE
Credential : MS, PT
Telephone Number : 770-465-5084
Provider Enumeration Date : 06/30/2006
Last Update Date : 08/22/2020

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Directions to “SIERRA THERAPY SERVICES, INC. ” Practice Location

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