Provider Demographics
NPI:1255737508
Name:FLORY, WENDY (PTA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:FLORY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7235 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30187-1717
Mailing Address - Country:US
Mailing Address - Phone:404-348-7330
Mailing Address - Fax:
Practice Address - Street 1:7235 HUMMINGBIRD LN
Practice Address - Street 2:
Practice Address - City:WINSTON
Practice Address - State:GA
Practice Address - Zip Code:30187-1717
Practice Address - Country:US
Practice Address - Phone:404-348-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA000188225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant