Atlanta International PT, Inc
Organization Active NPI Physical Therapist · Norcross, GA
NPI 1720100126 · NPPES record last updated Sep 23, 2009
Key facts
- NPI
- 1720100126
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 03810 (GA)
- Legal business name
- ATLANTA INTERNATIONAL PT, INC
- Practice address
- 3985 Steve Reynolds Blvd
BLDG G.
Norcross, GA 30093-3035 - Phone
- (770) 622-2532
- Fax
- (770) 622-2534
- NPI assigned
- Apr 4, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Sergio O Hernandez, PT.
- Title
- President and Owner
- Phone
- (770) 622-2532
Practitioners 35
-
Jamie Blake, OT
-
Caroline Malone Brannen, PT, DPT
-
Sarah Chesler, OTD, OTR/L
-
Daryll Dubal, P.T.
-
Erin Gish, PT, DPT
-
Barry L. Grau, MED
-
Melissa Heller, OT/R
-
Iyana Dorothy Hughes, SLP
-
Mary Kavishe, MS
-
Lauren Leever, OTR/L
-
Cortney Jo Maholtz, CCC-SLP
-
Kerone Maxineau, OTR/L
-
Angela Morozova, PT, MPT, DPT
-
Disha Sai Mudulodu, OTR/L
National Provider Directory
Locations
3985 Steve Reynolds Blvd
Bldg G
Norcross, GA 30093
Phone (770) 622-2532
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 03810 | GA | Yes |
| Occupational Therapist |
225X00000X | OT003725 | GA | |
| Occupational Therapist |
225X00000X | OT002773 | GA |
Addresses
Primary practice location
3985 Steve Reynolds Blvd
BLDG G.
Norcross, GA 30093-3035
Mailing address
3985 Steve Reynolds Blvd
BLDG G.
Norcross, GA 30093-3035
Phone (770) 622-2532
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00811148E | Medicaid | GA |
Other providers in Norcross, GA
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- Atlanta General Education Center
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- Atlanta Joint Specialist LLC
- Atlanta Oral & Maxillofacial Surgery, P.C.
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- Atlanta Pharmacy LLC
- Atlanta Surgery Group Specialists LLC
All providers in Norcross, 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 23, 2009. 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.