Provider Demographics
NPI:1689608374
Name:LARRIER, ELANA BIER (PT)
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:BIER
Last Name:LARRIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:BETH
Other - Last Name:BIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:4404 HUGH HOWELL RD
Practice Address - Street 2:STE 18
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4916
Practice Address - Country:US
Practice Address - Phone:770-493-5543
Practice Address - Fax:770-493-5549
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007863225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDRJMedicare ID - Type Unspecified
GA65BBDRKMedicare ID - Type Unspecified
GAGRP4895Medicare ID - Type UnspecifiedGROUP NUMBER
GAGRP7336Medicare ID - Type UnspecifiedGROUP NUMBER