Provider Demographics
NPI:1912108218
Name:PRATHER, ADRIAN NICHOLAS (PT)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:NICHOLAS
Last Name:PRATHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 DOYLE ST
Mailing Address - Street 2:STE 102
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-3676
Mailing Address - Country:US
Mailing Address - Phone:706-886-3486
Mailing Address - Fax:706-886-0379
Practice Address - Street 1:69 DOYLE ST STE 102
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-3676
Practice Address - Country:US
Practice Address - Phone:864-855-7030
Practice Address - Fax:864-855-7019
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008337225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist