Provider Demographics
NPI:1750635116
Name:GRATWICK, CAROLYN D (PT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:D
Last Name:GRATWICK
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 1:2669 OSBORNE RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-8400
Mailing Address - Country:US
Mailing Address - Phone:404-477-7777
Mailing Address - Fax:404-477-7000
Practice Address - Street 1:5342 TILLY MILL RD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4426
Practice Address - Country:US
Practice Address - Phone:678-812-4031
Practice Address - Fax:770-393-4374
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT003884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist