Provider Demographics
NPI:1538494828
Name:SET SPORTS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SET SPORTS PHYSICAL THERAPY
Other - Org Name:SET PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:LAINE
Authorized Official - Last Name:HUND
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:202-210-1131
Mailing Address - Street 1:1194 E ROCK SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2265
Mailing Address - Country:US
Mailing Address - Phone:202-210-1131
Mailing Address - Fax:
Practice Address - Street 1:1800 LAKE PARK DR SE STE 101
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7639
Practice Address - Country:US
Practice Address - Phone:202-210-1131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009748261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy