Provider Demographics
NPI:1750443339
Name:WEEKS, MICHELE CLOY (PT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:CLOY
Last Name:WEEKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 PARKWAY 575 STE 100
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3878
Mailing Address - Country:US
Mailing Address - Phone:770-591-5852
Mailing Address - Fax:
Practice Address - Street 1:335 PARKWAY 575 STE 100
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3878
Practice Address - Country:US
Practice Address - Phone:770-591-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0073662251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics