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NPI Code Detail

MEDICARE: EMORY PHYSICAL THERAPY, LLC

MEDICARE: EMORY 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 : 1922018423
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMORY PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 8259 WICKER AVE
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-8878
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 21 ORTHO LN
Second Line :
City : ATLANTA
State : GA
Zip : 30329-2315
Country : US
Telephone Number : 404-778-3350
Fax Number : 404-778-3185
Authorized Official
Title or Position : MANAGING PARTNER
Name : GREGORY COOPER
Credential :
Telephone Number : 219-365-6560
Provider Enumeration Date : 08/08/2006
Last Update Date : 04/15/2022

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Directions to “EMORY PHYSICAL THERAPY, LLC ” Practice Location

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