Provider Demographics
NPI:1639693245
Name:HARRISON, TERESA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LAKE PARK DR SE STE 101
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7639
Mailing Address - Country:US
Mailing Address - Phone:404-635-6343
Mailing Address - Fax:404-592-8895
Practice Address - Street 1:1800 LAKE PARK DR SE STE 101
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7639
Practice Address - Country:US
Practice Address - Phone:615-302-3564
Practice Address - Fax:615-302-3067
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist