Provider Demographics
NPI:1821795352
Name:LIANG, YONGHUA (PTA)
Entity Type:Individual
Prefix:MR
First Name:YONGHUA
Middle Name:
Last Name:LIANG
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 FOXHOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-9801
Mailing Address - Country:US
Mailing Address - Phone:646-515-9729
Mailing Address - Fax:
Practice Address - Street 1:610 FOXHOLLOW LN
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-9801
Practice Address - Country:US
Practice Address - Phone:646-515-9729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA004461225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant