Provider Demographics
NPI:1801183967
Name:HART, ANDREW CLAYTON (PT, DPT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CLAYTON
Last Name:HART
Suffix:
Gender:M
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E CROSSVILLE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7684
Mailing Address - Country:US
Mailing Address - Phone:678-822-0721
Mailing Address - Fax:678-822-0724
Practice Address - Street 1:24 E CROSSVILLE RD STE 150
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-7684
Practice Address - Country:US
Practice Address - Phone:678-822-0721
Practice Address - Fax:678-822-0724
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0103312251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic