Michael Gardner, DPT
Individual provider Active NPI Physical Therapist · Oakwood, GA
NPI 1275946105 · NPPES record last updated Jun 9, 2014
Key facts
- NPI
- 1275946105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT011469 (GA)
- Practice address
- 4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573 - Phone
- (678) 450-9933
- Fax
- (678) 450-9933
- NPI assigned
- Jun 9, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011469 | GA | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011469 | GA | Yes |
Addresses
Primary practice location
4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573
Mailing address
2400 Wisteria Dr
Suite a
Snellville, GA 30078-2689
Phone (770) 982-0102
Other providers in Oakwood, GA
- Maria Espana
- Extended Care Center of Oakwood LLC
- Eye Site of Oakwood P.C.
- Adeela Farisi
- Foot & Ankle Clinic of Oakwood, Inc.
- Newton B. Garrett
- Georgia CVS Pharmacy, L.L.C.
- Marti Renee Gibbs
- Olivia Gavala Gooden
- GPF Solutions LLC-Gigi'S Private Home Care
All providers in Oakwood, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 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.