Provider Demographics
NPI:1184075210
Name:PT SOLUTIONS OF ACWORTH LLC
Entity type:Organization
Organization Name:PT SOLUTIONS OF ACWORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-478-3792
Mailing Address - Street 1:1990 VAUGHN RD NW
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7098
Mailing Address - Country:US
Mailing Address - Phone:770-917-1395
Mailing Address - Fax:770-423-3369
Practice Address - Street 1:1615 RIDENOUR BLVD NW
Practice Address - Street 2:SUITE 204
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4463
Practice Address - Country:US
Practice Address - Phone:770-917-1395
Practice Address - Fax:770-423-3369
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PT SOLUTIONS OF ACWORTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty