Provider Demographics
NPI:1619021227
Name:WOLFF, NANCY E (MS,PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:WOLFF
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 MARIETTA HWY
Mailing Address - Street 2:SUITE 630-310
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-6755
Mailing Address - Country:US
Mailing Address - Phone:914-837-8297
Mailing Address - Fax:770-643-3788
Practice Address - Street 1:880 MARIETTA HWY
Practice Address - Street 2:SUITE 630-310
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-6755
Practice Address - Country:US
Practice Address - Phone:914-837-8297
Practice Address - Fax:770-643-3788
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist