Provider Demographics
NPI:1225540396
Name:REMEDY HOME THERAPY
Entity Type:Organization
Organization Name:REMEDY HOME THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ST. LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:413-214-4963
Mailing Address - Street 1:863 FLAT SHOALS RD SE
Mailing Address - Street 2:SUITE C #316
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094
Mailing Address - Country:US
Mailing Address - Phone:678-313-5943
Mailing Address - Fax:
Practice Address - Street 1:863 FLAT SHOALS RD SE
Practice Address - Street 2:SUITE C #316
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094
Practice Address - Country:US
Practice Address - Phone:678-313-5943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011238261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy