Roy Lee Grumbles, PHYSICAL THERAPIST

Individual provider Active NPI Physical Therapist · Sharpsburg, GA

NPI 1699829945 · NPPES record last updated Jun 17, 2008

Key facts

NPI
1699829945
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT000841 (GA)
Practice address
30 Bellview RDG
Sharpsburg, GA 30277-1556
Phone
(770) 463-3413
Fax
(770) 463-3517
NPI assigned
Jan 23, 2007
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)
No

State licenses

LicenseStateTypeSpecialty
PT000841GAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT000841 GA Yes

Addresses

Primary practice location

30 Bellview RDG
Sharpsburg, GA 30277-1556

Mailing address

30 Bellview RDG
Sharpsburg, GA 30277-1556
Phone (770) 463-3413

Other identifiers

IdentifierTypeStateIssuer
540949404AMedicaidGA

Other providers in Sharpsburg, GA

All providers in Sharpsburg, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.