Provider Demographics
NPI:1518374404
Name:ATCHESON, CELESTE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:ATCHESON
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HOWARD FARM DR STE 305
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6075
Mailing Address - Country:US
Mailing Address - Phone:678-908-4687
Mailing Address - Fax:
Practice Address - Street 1:5494 WEDGEWOOD CT SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-6564
Practice Address - Country:US
Practice Address - Phone:678-908-4687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-13
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0022712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer