MEDICARE: UPWARD THERAPY, L.L.C.

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	225100000X	Physical Therapist	005376	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407970072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPWARD THERAPY, L.L.C.

Provider Business Mailing Address
First Line	:	921 RICHMOND HILL DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4442
Country	:	US
Telephone Number	:	770-265-2474
Fax Number	:	770-518-0331

Provider Business Practice Location Address
First Line	:	921 RICHMOND HILL DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30068-4442
Country	:	US
Telephone Number	:	770-265-2474
Fax Number	:	770-518-0331

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KIMBERLY G. MILLER
Credential	:	M.P.T.
Telephone Number	:	770-265-2474

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	08/22/2020

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Directions to “UPWARD THERAPY, L.L.C. ” Practice Location

Language	Start Address	Practice Location

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