Provider Demographics
NPI:1588844914
Name:HARPER, PEGGY CASEY (PT)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:CASEY
Last Name:HARPER
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 1:345 RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2620
Mailing Address - Country:US
Mailing Address - Phone:770-641-9239
Mailing Address - Fax:770-641-9335
Practice Address - Street 1:345 RIDGE CT
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2620
Practice Address - Country:US
Practice Address - Phone:770-641-9239
Practice Address - Fax:770-641-9335
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT002722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist