Provider Demographics
NPI:1992269807
Name:THERAPY EXCELLENCE
Entity type:Organization
Organization Name:THERAPY EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAITER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:770-459-6533
Mailing Address - Street 1:2001 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-4720
Mailing Address - Country:US
Mailing Address - Phone:770-459-6533
Mailing Address - Fax:770-462-1260
Practice Address - Street 1:113 COMMONS WAY STE 402
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-7040
Practice Address - Country:US
Practice Address - Phone:770-459-6533
Practice Address - Fax:770-462-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty