Provider Demographics
NPI:1548402563
Name:BATUGAL, MARIA REBECCA (PT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:REBECCA
Last Name:BATUGAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5740 STEPHENS MILL DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8403
Mailing Address - Country:US
Mailing Address - Phone:678-546-9319
Mailing Address - Fax:770-465-5304
Practice Address - Street 1:2155 W PARK CT
Practice Address - Street 2:SUITE G
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3500
Practice Address - Country:US
Practice Address - Phone:770-465-5084
Practice Address - Fax:770-465-5304
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist