MEDICARE: PHYSIOHEALTH

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1699535682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOHEALTH

Provider Business Mailing Address
First Line	:	275 CARPENTER DR STE 304
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4911
Country	:	US
Telephone Number	:	770-570-6967
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 CARPENTER DR STE 304
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4911
Country	:	US
Telephone Number	:	770-570-6967
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	DENISE A DAISY
Credential	:
Telephone Number	:	770-570-6967

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	09/02/2024

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Directions to “PHYSIOHEALTH ” Practice Location

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