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
-
Laquanda Shuntay White, P.T.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
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
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- Charity Personal Care Home L.L.C.
- Nicole Chavannes
- Christ the King Day Habilitation Services, Inc.
- Anthony Chukwukelue
- Cityviewhealthcare
- CJR Special Transportation LLC
- Clayton Pharma LLC
- Coastal Community Senior Living Services LLC
- Nyeshia Sherelle Cohill
All providers in College Park, GA · Physical Therapist 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 2, 2020. 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.