Provider Demographics
NPI:1013587799
Name:NEHAMA SCHONDORF DPT LLC
Entity Type:Organization
Organization Name:NEHAMA SCHONDORF DPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NEHAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHONDORF
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:678-462-1190
Mailing Address - Street 1:2187 SHASTA WAY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2601
Mailing Address - Country:US
Mailing Address - Phone:678-462-1190
Mailing Address - Fax:
Practice Address - Street 1:2310 PARKLAKE DR NE STE 175
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2913
Practice Address - Country:US
Practice Address - Phone:678-462-1190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty