Nelly Esperanza Lunz
Individual provider Active NPI Physical Therapy Assistant · Sugar Hill, GA
NPI 1255895504 · NPPES record last updated Jan 30, 2019
Key facts
- NPI
- 1255895504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 004155 (GA)
- Practice address
- 6009 Suwanee Dam Rd
Sugar Hill, GA 30518-5514 - Phone
- (770) 904-0099
- NPI assigned
- Jan 30, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 004155 | GA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 004155 | GA | Yes |
Addresses
Primary practice location
6009 Suwanee Dam Rd
Sugar Hill, GA 30518-5514
Mailing address
5680 Stephens Mill Dr
Sugar Hill, GA 30518-8432
Phone (347) 414-2662
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All providers in Sugar Hill, 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 Jan 30, 2019. 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.