Provider Demographics
NPI:1598727760
Name:HARDWICK, MISCHELLE E (DPT)
Entity Type:Individual
Prefix:MISS
First Name:MISCHELLE
Middle Name:E
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MISCHELLE
Other - Middle Name:N
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2365 OLD MILTON PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2140
Mailing Address - Country:US
Mailing Address - Phone:770-740-1860
Mailing Address - Fax:678-347-2104
Practice Address - Street 1:1000 COMMERCE DR STE 200
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3520
Practice Address - Country:US
Practice Address - Phone:770-740-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q04069Medicare UPIN