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NPI Code Detail

MEDICARE: MARILYN ABRAHAM PT

MEDICARE: MARILYN ABRAHAM PT
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 TherapistPT016982GA

General Provider Information

NPI Number : 1437714870
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN ABRAHAM PT
Provider Business Mailing Address
First Line : 3708 NORTHSIDE DR
Second Line :
City : MACON
State : GA
Zip : 31210-2404
Country : US
Telephone Number : 478-745-4206
Fax Number : 478-254-5463
Provider Business Practice Location Address
First Line : 2510 GA HIGHWAY 127
Second Line :
City : KATHLEEN
State : GA
Zip : 31047-2828
Country : US
Telephone Number : 478-971-1153
Fax Number : 478-971-1171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2019
Last Update Date : 02/01/2024

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