Provider Demographics
NPI:1043659915
Name:REED, MONICA SHANELL (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:SHANELL
Last Name:REED
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:745 CHASTAIN RD NW
Mailing Address - Street 2:SUITE 1130
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-3000
Mailing Address - Country:US
Mailing Address - Phone:770-425-2440
Mailing Address - Fax:770-425-8877
Practice Address - Street 1:745 CHASTAIN RD NW
Practice Address - Street 2:SUITE 1130
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-3000
Practice Address - Country:US
Practice Address - Phone:770-425-2440
Practice Address - Fax:770-425-8877
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist