MEDICARE: DR. KAITLIN C GRAVES PT, DPT

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	PT018122	GA

General Provider Information

NPI Number	:	1992668651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAITLIN C GRAVES PT, DPT

Provider Business Mailing Address
First Line	:	2810 PACES FERRY RD SE STE 132
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5700
Country	:	US
Telephone Number	:	470-531-1180
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 PACES FERRY RD SE STE 132
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5700
Country	:	US
Telephone Number	:	470-531-1180
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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