MEDICARE: CARISA HUNSUCKER P.T.

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	PT006071	GA

General Provider Information

NPI Number	:	1538238829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARISA HUNSUCKER P.T.

Provider Business Mailing Address
First Line	:	2897 N DRUID HILLS RD NE
Second Line	:	SUITE 280
City	:	ATLANTA
State	:	GA
Zip	:	30329-3924
Country	:	US
Telephone Number	:	678-902-5833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2897 N DRUID HILLS RD NE
Second Line	:	SUITE 280
City	:	ATLANTA
State	:	GA
Zip	:	30329-3924
Country	:	US
Telephone Number	:	678-902-5833
Fax Number	:

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	02/13/2017

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