Citrine Therapy Source

Organization Active NPI Physical Therapist · College Park, GA

NPI 1700490265 · NPPES record last updated Sep 2, 2020

Key facts

NPI
1700490265
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
CITRINE THERAPY SOURCE
Practice address
5678 Greensage Dr
College Park, GA 30349-8739
Phone
(678) 640-5396
NPI assigned
Sep 2, 2020
Organization subpart
No

Authorized official

Name
Mrs. Laquanda White, PT
Title
Ceo/Physical Therapist
Phone
(678) 640-5396

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

5678 Greensage Dr
College Park, GA 30349-8739

Mailing address

5678 Greensage Dr
College Park, GA 30349-8739
Phone (678) 640-5396

Other providers in College Park, GA

All providers in College Park, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.