Provider Demographics
NPI:1942362447
Name:TIGER, VANESSA LAUREN (MPT)
Entity Type:Individual
Prefix:MISS
First Name:VANESSA
Middle Name:LAUREN
Last Name:TIGER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3035
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:770-953-6972
Practice Address - Street 1:5205 STILESBORO RD NW
Practice Address - Street 2:BUILDING II, SUITE 250
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7764
Practice Address - Country:US
Practice Address - Phone:770-218-8800
Practice Address - Fax:770-218-8811
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT007837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist