Provider Demographics
NPI:1811725609
Name:VUE, DAVID KWM (DPT, PT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KWM
Last Name:VUE
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0949
Mailing Address - Country:US
Mailing Address - Phone:904-261-4414
Mailing Address - Fax:904-261-4614
Practice Address - Street 1:100 LINDSEY LN STE A
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-1727
Practice Address - Country:US
Practice Address - Phone:912-729-1333
Practice Address - Fax:912-729-5259
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42021225100000X
GAPT017582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist