Gwinnett Sportherapy

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT004490 Issued in GA

Legal business name

GWINNETT SPORTHERAPY

Practice address

965 Oakland Rd Ste 2C
Lawrenceville, GA 30044-3758

Phone

(770) 962-2228

Fax

(770) 962-2332

NPI assigned

Mar 24, 2008

Last updated

Mar 24, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sonya Weaver Wright, MPT

Title

Manager

Phone

(770) 962-2228

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1265604896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 OAKLAND RD STE 2C",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443758",
            "telephone_number": "770-962-2228",
            "fax_number": "770-962-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 OAKLAND RD STE 2C",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300443758",
            "telephone_number": "770-962-2228",
            "fax_number": "770-962-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT SPORTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "WEAVER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-962-2228",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "PT004490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.