MEDICARE: KERRI APPLEGATE 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	PT007959	GA

General Provider Information

NPI Number	:	1922304823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI APPLEGATE PT

Provider Business Mailing Address
First Line	:	1092 MENDELL CIRCLE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319
Country	:	US
Telephone Number	:	770-256-9921
Fax Number	:	404-228-7107

Provider Business Practice Location Address
First Line	:	1092 MENDELL CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-2327
Country	:	US
Telephone Number	:	770-256-9921
Fax Number	:	404-228-7107

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

Provider Enumeration Date	:	02/10/2011
Last Update Date	:	02/10/2011

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Directions to “ KERRI APPLEGATE PT” Practice Location

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