Provider Demographics
NPI:1649670746
Name:SALISBURY, JASON (PT, DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8492 HIRAM ACWORTH HWY STE 211
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-4710
Mailing Address - Country:US
Mailing Address - Phone:678-687-0630
Mailing Address - Fax:678-647-7985
Practice Address - Street 1:8492 HIRAM ACWORTH HWY STE 211
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-4710
Practice Address - Country:US
Practice Address - Phone:678-687-0630
Practice Address - Fax:678-647-7985
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist