Provider Demographics
NPI:1376524363
Name:DARBY PHYSICAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:DARBY PHYSICAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-471-1004
Mailing Address - Street 1:248 TOM HILL SR BLVD
Mailing Address - Street 2:#331
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1815
Mailing Address - Country:US
Mailing Address - Phone:478-474-8847
Mailing Address - Fax:
Practice Address - Street 1:3200 RIVERSIDE DR
Practice Address - Street 2:SUITE 300-A
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2550
Practice Address - Country:US
Practice Address - Phone:478-471-1004
Practice Address - Fax:478-471-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005662224Z00000X, 225100000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty