Provider Demographics
NPI:1467645689
Name:HIGH PERFORMANCE PHYSICAL THERAPY CENTERS
Entity type:Organization
Organization Name:HIGH PERFORMANCE PHYSICAL THERAPY CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT & TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:VICKERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-367-2120
Mailing Address - Street 1:3223 HOWELL MILL RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4105
Mailing Address - Country:US
Mailing Address - Phone:404-367-2111
Mailing Address - Fax:404-367-2147
Practice Address - Street 1:1180 SATELLITE BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4636
Practice Address - Country:US
Practice Address - Phone:404-367-2200
Practice Address - Fax:404-367-2147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty