Provider Demographics
NPI:1760138861
Name:REACH PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:REACH PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:404-493-3514
Mailing Address - Street 1:280 INTERSTATE NORTH CIR SE STE 105
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2450
Mailing Address - Country:US
Mailing Address - Phone:678-608-1700
Mailing Address - Fax:678-608-1699
Practice Address - Street 1:280 INTERSTATE NORTH CIR SE STE 105
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2450
Practice Address - Country:US
Practice Address - Phone:678-608-1700
Practice Address - Fax:678-608-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy