Provider Demographics
NPI:1821525064
Name:COMPLETE PHYSICAL THERAPY CENTERS OF GEORGIA, LLC
Entity Type:Organization
Organization Name:COMPLETE PHYSICAL THERAPY CENTERS OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:GIOVINCO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:678-561-9000
Mailing Address - Street 1:1975 HIGHWAY 54 W STE 205
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4794
Mailing Address - Country:US
Mailing Address - Phone:678-561-9000
Mailing Address - Fax:678-854-1977
Practice Address - Street 1:1975 HIGHWAY 54 W STE 210B
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4794
Practice Address - Country:US
Practice Address - Phone:770-632-2060
Practice Address - Fax:770-487-6717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-18
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty