Provider Demographics
NPI:1982729141
Name:PHYSICAL THERAPY SPECIALISTS, INC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FRAME
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS
Authorized Official - Phone:770-934-5712
Mailing Address - Street 1:2171 NORTHLAKE PKWY
Mailing Address - Street 2:SUITE 118
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4104
Mailing Address - Country:US
Mailing Address - Phone:770-934-5712
Mailing Address - Fax:770-934-5728
Practice Address - Street 1:2171 NORTHLAKE PKWY
Practice Address - Street 2:SUITE 118
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4104
Practice Address - Country:US
Practice Address - Phone:770-934-5712
Practice Address - Fax:770-934-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4845Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER