Provider Demographics
NPI:1295959880
Name:HAMILTON MILL MEDICAL & PHYSICAL THERAPY
Entity type:Organization
Organization Name:HAMILTON MILL MEDICAL & PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-614-4060
Mailing Address - Street 1:2098 TERON TRCE
Mailing Address - Street 2:STE 300
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2098 TERON TRCE
Practice Address - Street 2:STE 300
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1662
Practice Address - Country:US
Practice Address - Phone:770-614-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty