Provider Demographics
NPI:1912334053
Name:ABERCROMBIE, LINDA CHRISTINE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CHRISTINE
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:PTA
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 371
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30663-0371
Mailing Address - Country:US
Mailing Address - Phone:770-377-4667
Mailing Address - Fax:
Practice Address - Street 1:1201 SILOAM RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:GA
Practice Address - Zip Code:30642-2811
Practice Address - Country:US
Practice Address - Phone:706-453-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA001626225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant