Justine Garcia

Individual provider Active NPI Physical Therapist · Byron, GA

NPI 1386097780 · NPPES record last updated Jul 20, 2016

Key facts

NPI
1386097780
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT012192 (GA)
Practice address
100 Hamilton Pointe Drive
Suite 115
Byron, GA 31008
Phone
(478) 956-4916
Fax
(478) 956-0401
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT012192GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Georgia Family Rehab Past
since Sep 16, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012192 GA Yes

Addresses

Primary practice location

100 Hamilton Pointe Drive
Suite 115
Byron, GA 31008

Mailing address

PO Box 1552
Byron, GA 31008-1552

Other providers in Byron, GA

All providers in Byron, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.