Theresa Feanny
Individual provider Active NPI Physical Therapy Assistant · Locust Grove, GA
NPI 1013332873 · NPPES record last updated Mar 3, 2014
Key facts
- NPI
- 1013332873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA002181 (GA)
- Practice address
- 183 Lantana Dr
Locust Grove, GA 30248-7094 - Phone
- (404) 232-5762
- NPI assigned
- Mar 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA002181 | GA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA002181 | GA | Yes |
Addresses
Primary practice location
183 Lantana Dr
Locust Grove, GA 30248-7094
Mailing address
183 Lantana Dr
Locust Grove, GA 30248-7094
Other providers in Locust Grove, GA
- Envisioned Purpose LLC
- Jameson Andrew Estes
- Erica Evans
- David Farmer
- Linda Faulkner
- Jean Robert Ferdinand
- Nateka Fielder
- Four Corners Testing LLC
- Regan Joy Frake
- Tieara Freeman
All providers in Locust Grove, GA · Physical Therapy Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.