Michael Kwaku Agyemang

Individual provider Active NPI Occupational Therapist · Decatur, GA

NPI 1669926754 · NPPES record last updated Aug 7, 2016

Key facts

NPI
1669926754
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT005890 (GA)
Practice address
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone
(404) 321-6111
NPI assigned
Aug 7, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT005890 GA Yes

Addresses

Primary practice location

1670 Clairmont Rd
Decatur, GA 30033-4004

Mailing address

4201 Rutherford Glen Cir
Atlanta, GA 30340-3887
Phone (614) 561-6244

Other providers in Decatur, GA

All providers in Decatur, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.