Provider Demographics
NPI:1952048605
Name:BETTIO PHYSICAL THERAPY AND SPORT REHABILITATION LLC
Entity Type:Organization
Organization Name:BETTIO PHYSICAL THERAPY AND SPORT REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTIO
Authorized Official - Suffix:
Authorized Official - Credentials:MSRPT
Authorized Official - Phone:912-547-5580
Mailing Address - Street 1:8872 FORD AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-6092
Mailing Address - Country:US
Mailing Address - Phone:912-312-2766
Mailing Address - Fax:
Practice Address - Street 1:8872 FORD AVE STE 206
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-6092
Practice Address - Country:US
Practice Address - Phone:912-312-2766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-15
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty