Provider Demographics
NPI:1083999718
Name:ABRAMS, VANESSA M (ATC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:M
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SPELMAN LN SW
Mailing Address - Street 2:BOX 1057
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-4395
Mailing Address - Country:US
Mailing Address - Phone:404-392-4916
Mailing Address - Fax:404-270-5714
Practice Address - Street 1:350 SPELMAN LN SW
Practice Address - Street 2:BOX 1057
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-4395
Practice Address - Country:US
Practice Address - Phone:404-392-4916
Practice Address - Fax:404-270-5714
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0018962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer