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NPI Code Detail

MEDICARE: OBINNA NTIASAGWE PT, DPT

MEDICARE: OBINNA NTIASAGWE PT, DPT
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 TherapistPT018224GA

General Provider Information

NPI Number : 1518801323
Entity Type Code : Individual
Provider Name (Legal Business Name) : OBINNA NTIASAGWE PT, DPT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 WHITE ST SW STE 300
Second Line :
City : ATLANTA
State : GA
Zip : 30310-2634
Country : US
Telephone Number : 470-905-2800
Fax Number : 470-905-2801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/15/2026

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Directions to “ OBINNA NTIASAGWE PT, DPT” Practice Location

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