Provider Demographics
NPI:1619636495
Name:PT SOLUTIONS OF MONTGOMERY, LLC
Entity Type:Organization
Organization Name:PT SOLUTIONS OF MONTGOMERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-459-3758
Mailing Address - Street 1:1100 CIRCLE 75 PKWY SE STE 1400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3067
Mailing Address - Country:US
Mailing Address - Phone:678-459-3759
Mailing Address - Fax:678-567-6737
Practice Address - Street 1:209 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:AL
Practice Address - Zip Code:35051-9724
Practice Address - Country:US
Practice Address - Phone:678-528-2076
Practice Address - Fax:678-528-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty