Provider Demographics
NPI:1336868306
Name:MARCY, ALLYSON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:MARCY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:
Other - Last Name:MARCY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4520 OLDE PERIMETER WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-1294
Mailing Address - Country:US
Mailing Address - Phone:404-551-3099
Mailing Address - Fax:
Practice Address - Street 1:4520 OLDE PERIMETER WAY STE 110
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-1294
Practice Address - Country:US
Practice Address - Phone:404-551-3099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist