Provider Demographics
NPI:1205513157
Name:PIEDRA, JANETTE VIRGINIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:JANETTE
Middle Name:VIRGINIA
Last Name:PIEDRA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:1706 HIGHWAY 129 S STE B
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-4945
Practice Address - Country:US
Practice Address - Phone:706-219-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT5761225100000X
WVPT004701225100000X
GAPT017488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVPT004701OtherWEST VIRGINIA BOARD OF PHYSICAL THERAPY
NMPT5761OtherSTATE OF NEW MEXICO PHYSICAL THERAPY BOARD