Provider Demographics
NPI:1083166565
Name:PT SOLUTIONS OF ACWORTH, LLC
Entity Type:Organization
Organization Name:PT SOLUTIONS OF ACWORTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-615-4856
Mailing Address - Street 1:PO BOX 441146
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30160-9522
Mailing Address - Country:US
Mailing Address - Phone:770-917-1935
Mailing Address - Fax:
Practice Address - Street 1:3575 DURDEN DR NE STE 304-A
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-2253
Practice Address - Country:US
Practice Address - Phone:678-831-7759
Practice Address - Fax:678-831-7779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PT SOLUTIONS OF ACWORTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty