Provider Demographics
NPI:1326247248
Name:INTEGRATED THERAPY LLC
Entity Type:Organization
Organization Name:INTEGRATED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-351-5307
Mailing Address - Street 1:2221 PEACHTREE RD NE
Mailing Address - Street 2:STE D336
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1148
Mailing Address - Country:US
Mailing Address - Phone:404-351-5307
Mailing Address - Fax:404-351-5308
Practice Address - Street 1:2221 PEACHTREE RD NE
Practice Address - Street 2:STE D336
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1148
Practice Address - Country:US
Practice Address - Phone:404-351-5307
Practice Address - Fax:404-351-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA082388LG8225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3723OtherMEDICARE GROUP NUMBER