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NPI Code Detail

MEDICARE: BETSY MURRILL HAMILTON PTA

MEDICARE: BETSY MURRILL HAMILTON PTA
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
1225200000XPhysical Therapy AssistantPTA001629GA

General Provider Information

NPI Number : 1639463383
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETSY MURRILL HAMILTON PTA
Provider Business Mailing Address
First Line : 1865 BOLD SPRINGS RD NW
Second Line :
City : MONROE
State : GA
Zip : 30656-4605
Country : US
Telephone Number : 770-267-1055
Fax Number : 770-267-1054
Provider Business Practice Location Address
First Line : 1865 BOLD SPRINGS RD NW
Second Line :
City : MONROE
State : GA
Zip : 30656-4605
Country : US
Telephone Number : 770-267-1055
Fax Number : 770-267-1054
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2011
Last Update Date : 05/30/2011

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