Turner Blackburn, PT

Individual provider Active NPI Physical Therapist · Manchester, GA

NPI 1629136049 · NPPES record last updated Jan 10, 2017

Key facts

NPI
1629136049
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
676 (GA)
Practice address
1140 Warm Springs Hwy
Manchester, GA 31816-1166
Phone
(706) 846-3717
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

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)
Yes

State licenses

LicenseStateTypeSpecialty
676GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clemson Sports Medicine and Rehabilitation, Inc Past
since Apr 19, 2006
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 676 GA Yes

Addresses

Primary practice location

1140 Warm Springs Hwy
Manchester, GA 31816-1166

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other providers in Manchester, GA

All providers in Manchester, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.