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NPI Code Detail

MEDICARE: DRAYER PHYSICAL THERAPY INSTITUTE LLC

MEDICARE: DRAYER PHYSICAL THERAPY INSTITUTE LLC
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 Therapist

General Provider Information

NPI Number : 1710213756
Entity Type Code : Organization
Provider Name (Legal Business Name) : DRAYER PHYSICAL THERAPY INSTITUTE LLC
Provider Business Mailing Address
First Line : 611 HIGHWAY 74 S
Second Line : SUITE 720
City : PEACHTREE CITY
State : GA
Zip : 30269-3081
Country : US
Telephone Number : 770-632-6800
Fax Number : 770-632-6060
Provider Business Practice Location Address
First Line : 611 HIGHWAY 74 S
Second Line : SUITE 720
City : PEACHTREE CITY
State : GA
Zip : 30269-3081
Country : US
Telephone Number : 770-632-6800
Fax Number : 770-632-6060
Authorized Official
Title or Position : CEO
Name : LUKE A DRAYER
Credential :
Telephone Number : 717-220-2100
Provider Enumeration Date : 10/27/2009
Last Update Date : 01/29/2010

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