Provider Demographics
NPI:1326695461
Name:ONE STOP PHYSICAL THERAPY, WELLNESS AND HOME SAFETY LLC
Entity Type:Organization
Organization Name:ONE STOP PHYSICAL THERAPY, WELLNESS AND HOME SAFETY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:KALENIK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:770-842-0457
Mailing Address - Street 1:3300 HAMILTON MILL RD STE 102-271
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4080
Mailing Address - Country:US
Mailing Address - Phone:770-842-0457
Mailing Address - Fax:
Practice Address - Street 1:3694 LAKE RABUN CT
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-3786
Practice Address - Country:US
Practice Address - Phone:770-842-0457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy