Provider Demographics
NPI:1184028987
Name:KILDAY, ERICA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:KILDAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SMOKE HILL LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-7401
Mailing Address - Country:US
Mailing Address - Phone:404-425-1222
Mailing Address - Fax:844-239-7756
Practice Address - Street 1:105 SMOKE HILL LN
Practice Address - Street 2:SUITE 120
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7401
Practice Address - Country:US
Practice Address - Phone:404-425-1222
Practice Address - Fax:844-239-7756
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist