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NPI Code Detail

MEDICARE: THERESA CORREA PT

MEDICARE:   THERESA  CORREA  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 TherapistPT008590GA

General Provider Information

NPI Number : 1629364237
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA CORREA PT
Provider Business Mailing Address
First Line : 2669 OSBORNE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-8400
Country : US
Telephone Number : 404-477-7777
Fax Number : 404-477-7000
Provider Business Practice Location Address
First Line : 2669 OSBORNE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-8400
Country : US
Telephone Number : 404-477-7777
Fax Number : 404-477-7000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2011
Last Update Date : 06/22/2011

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Directions to “ THERESA CORREA PT” Practice Location

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