Provider Demographics
NPI:1295722205
Name:REID, APOLLONE SIMONE (PT, MPH)
Entity type:Individual
Prefix:MRS
First Name:APOLLONE
Middle Name:SIMONE
Last Name:REID
Suffix:
Gender:F
Credentials:PT, MPH
Other - Prefix:MRS
Other - First Name:APOLLONE
Other - Middle Name:SIMONE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPH
Mailing Address - Street 1:718 SMALL ELK CT
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-1022
Mailing Address - Country:US
Mailing Address - Phone:404-518-8206
Mailing Address - Fax:404-292-4452
Practice Address - Street 1:718 SMALL ELK CT
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-1022
Practice Address - Country:US
Practice Address - Phone:404-518-8206
Practice Address - Fax:404-292-4452
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT001355225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist