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NPI Code Detail

MEDICARE: TMJ PHYSICAL THERAPY LLC

MEDICARE: TMJ PHYSICAL THERAPY 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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1851288054
Entity Type Code : Organization
Provider Name (Legal Business Name) : TMJ PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 930 WOODSTOCK RD STE 310
Second Line :
City : ROSWELL
State : GA
Zip : 30075-2220
Country : US
Telephone Number : 404-868-7994
Fax Number :
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 : 404-868-7994
Fax Number :
Authorized Official
Title or Position : OWNER, PHYSICAL THERAPIST
Name : DR. BRENDAN THOMAS GLACKIN
Credential : DPT
Telephone Number : 404-868-7994
Provider Enumeration Date : 06/20/2025
Last Update Date : 03/05/2026

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Directions to “TMJ PHYSICAL THERAPY LLC ” Practice Location

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