Provider Demographics
NPI:1477577484
Name:DAVIS, ANTONIO T (MPT)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:T
Last Name:DAVIS
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Gender:M
Credentials:MPT
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Mailing Address - Street 1:900 CIRCLE 75 PKWY SE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3035
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:354 NEWNAN CROSSING BYP
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2323
Practice Address - Country:US
Practice Address - Phone:770-460-4747
Practice Address - Fax:678-673-5102
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-06-03
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Provider Licenses
StateLicense IDTaxonomies
GAPT0077212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic