Provider Demographics
NPI:1144243817
Name:KAFATI, JOSEPH O (DPT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:O
Last Name:KAFATI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1432 TOWNE LAKE PKWY
Mailing Address - Street 2:STE 120
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-8264
Mailing Address - Country:US
Mailing Address - Phone:678-445-9799
Mailing Address - Fax:678-445-2688
Practice Address - Street 1:1432 TOWNE LAKE PKWY
Practice Address - Street 2:STE 120
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-8264
Practice Address - Country:US
Practice Address - Phone:678-445-9799
Practice Address - Fax:678-445-2688
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA7300225100000X
GAPT007300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7913Medicare PIN
GA65BBDXMMedicare PIN