Marie Therese Vazquez, PTA
Individual provider Active NPI Physical Therapy Assistant · East Ellijay, GA
NPI 1669955746 · NPPES record last updated Sep 13, 2018
Key facts
- NPI
- 1669955746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA003184 (GA)
- Practice address
- 190 Old Orchard SQ
East Ellijay, GA 30540-8172 - Phone
- (706) 273-3131
- Fax
- (706) 273-3133
- NPI assigned
- Sep 13, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA003184 | GA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA003184 | GA | Yes |
Addresses
Primary practice location
190 Old Orchard SQ
East Ellijay, GA 30540-8172
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217
Other providers in East Ellijay, GA
- Celeste Nicole Taylor
- Sarah Marie Taylor
- Nadine American Thomas
- Anne Berry Todd
- James Gary Tomblin
- Wal-Mart Stores East, LP
- Loretta Walborn
- Walgreen Co
- Walmart Pharmacy #1070
All providers in East Ellijay, GA · Physical Therapy Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2018. 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.