Provider Demographics
NPI:1962636035
Name:KALARIA, POOJA H (PT)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:H
Last Name:KALARIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 GREAT OAKS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-8211
Mailing Address - Country:US
Mailing Address - Phone:770-207-6624
Mailing Address - Fax:770-207-6631
Practice Address - Street 1:517 GREAT OAKS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-8211
Practice Address - Country:US
Practice Address - Phone:770-207-6624
Practice Address - Fax:770-207-6631
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT009540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist