Blake Darren Aldridge, PTA
Individual provider Active NPI Physical Therapy Assistant · Waycross, GA
NPI 1962940478 · NPPES record last updated Feb 3, 2017
Key facts
- NPI
- 1962940478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA003749 (GA)
- Practice address
- 401 Preston Street
Waycross, GA 31501 - Phone
- (912) 283-7342
- Fax
- (912) 283-7402
- NPI assigned
- Feb 3, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| PTA003749 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ware County Physical Therapy, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA003749 | GA | Yes |
Addresses
Primary practice location
401 Preston Street
Waycross, GA 31501
Mailing address
401 Preston St
Waycross, GA 31501-5248
Phone (912) 283-7342
Other providers in Waycross, GA
- Air Evac EMS, Inc.
- Oladotun Akintomide
- John W Akridge Jr.
- Andrea Janan Albritton
- Alison H Alderin
- Colleen Heather Aldridge
- Kayla Casey Aldridge
- Kelli Alford
- Tayler Hutto Allen
- Altomese Neloms Host Home
All providers in Waycross, 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 Feb 3, 2017. 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.