Provider Demographics
NPI:1245649722
Name:NOURPARVAR, HOOMAN
Entity type:Individual
Prefix:
First Name:HOOMAN
Middle Name:
Last Name:NOURPARVAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0949
Mailing Address - Country:US
Mailing Address - Phone:404-367-2086
Mailing Address - Fax:678-213-1705
Practice Address - Street 1:1809 CANTON RD STE 600
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6389
Practice Address - Country:US
Practice Address - Phone:043-672-0864
Practice Address - Fax:678-213-1705
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011634225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist