Provider Demographics
NPI:1881761450
Name:CUMMINGS PHYSICAL THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:CUMMINGS PHYSICAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:678-234-3074
Mailing Address - Street 1:1179 BEN JONES RD
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-3108
Mailing Address - Country:US
Mailing Address - Phone:678-234-3074
Mailing Address - Fax:706-754-1406
Practice Address - Street 1:1179 BEN JONES ROAD
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523
Practice Address - Country:US
Practice Address - Phone:678-234-3074
Practice Address - Fax:706-754-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT 007349174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty