Provider Demographics
NPI:1841352804
Name:KERR, JUDY ANN (MPT)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:KERR
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 HOSPITAL BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4907
Mailing Address - Country:US
Mailing Address - Phone:770-664-9600
Mailing Address - Fax:
Practice Address - Street 1:11050 CRABAPPLE RD
Practice Address - Street 2:SUITE 114D
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2489
Practice Address - Country:US
Practice Address - Phone:770-650-4055
Practice Address - Fax:770-650-4453
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT002588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDFPMedicare ID - Type Unspecified