Provider Demographics
NPI:1326274663
Name:HIPPO ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HIPPO ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:ROBERTSON
Authorized Official - Last Name:MADDUX
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:678-736-0724
Mailing Address - Street 1:325 WAVERLY HALL CIR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2110
Mailing Address - Country:US
Mailing Address - Phone:678-736-0724
Mailing Address - Fax:
Practice Address - Street 1:1055 THOMAS RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-6702
Practice Address - Country:US
Practice Address - Phone:678-736-0724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty