Provider Demographics
NPI:1629188222
Name:VIGELIS, RAMUNAS J
Entity Type:Individual
Prefix:
First Name:RAMUNAS
Middle Name:J
Last Name:VIGELIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 ROSELANE ST NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7902
Mailing Address - Country:US
Mailing Address - Phone:470-259-5226
Mailing Address - Fax:267-321-2044
Practice Address - Street 1:805 SAINT VINCENTS DR
Practice Address - Street 2:SUITE A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1636
Practice Address - Country:US
Practice Address - Phone:205-212-9435
Practice Address - Fax:205-212-3229
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2627OtherLICENSE #
AL2627OtherLICENSE #
AL102G652859Medicare PIN