Provider Demographics
NPI:1578640330
Name:EABY, JOEL A (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:EABY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2500 OLD ALABAMA RD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2400
Mailing Address - Country:US
Mailing Address - Phone:678-400-0300
Mailing Address - Fax:678-400-0131
Practice Address - Street 1:2500 OLD ALABAMA RD
Practice Address - Street 2:SUITE 24
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2400
Practice Address - Country:US
Practice Address - Phone:678-400-0300
Practice Address - Fax:678-400-0131
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist