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NPI Code Detail

MEDICARE: MS. LANA BEA TOBIN D.P.T.

MEDICARE:  MS. LANA BEA TOBIN  D.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
1225100000XPhysical TherapistPT009820GA

General Provider Information

NPI Number : 1629206636
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LANA BEA TOBIN D.P.T.
Provider Business Mailing Address
First Line : 5871 GLENRIDGE DRIVE
Second Line : SUITE 110
City : ATLANTA
State : GA
Zip : 30328
Country : US
Telephone Number : 770-415-9165
Fax Number : 678-280-2416
Provider Business Practice Location Address
First Line : 5871 GLENRIDGE DR STE 110
Second Line :
City : ATLANTA
State : GA
Zip : 30328-5304
Country : US
Telephone Number : 770-415-9165
Fax Number : 678-280-2416
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2009
Last Update Date : 09/26/2017

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