MEDICARE: MARK GREENSPAN MSPT

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	225100000X	Physical Therapist	PT006319	GA

General Provider Information

NPI Number	:	1801965074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK GREENSPAN MSPT

Provider Business Mailing Address
First Line	:	800 CRESCENT CENTRE DR STE 300
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7285
Country	:	US
Telephone Number	:	615-416-0199
Fax Number	:	615-221-9054

Provider Business Practice Location Address
First Line	:	930 WOODSTOCK RD STE 310
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-2220
Country	:	US
Telephone Number	:	770-998-6636
Fax Number	:	770-998-6646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	08/22/2024

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Directions to “ MARK GREENSPAN MSPT” Practice Location

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