MEDICARE: PUNEETH KORTEGERI 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
1	225100000X	Physical Therapist	PT013115	GA

General Provider Information

NPI Number	:	1821378720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PUNEETH KORTEGERI PT

Provider Business Mailing Address
First Line	:	PO BOX 306393
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37230-6393
Country	:	US
Telephone Number	:	615-373-1350
Fax Number	:

Provider Business Practice Location Address
First Line	:	2059 SCENIC HWY N STE C
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-6142
Country	:	US
Telephone Number	:	470-568-2818
Fax Number	:	470-427-2480

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

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	09/30/2021

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Directions to “ PUNEETH KORTEGERI PT” Practice Location

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