Provider Demographics
NPI:1982807400
Name:BYLES, ERIC (PT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BYLES
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 1:1985 HOWELL MILL RD NW
Mailing Address - Street 2:STE. B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2566
Mailing Address - Country:US
Mailing Address - Phone:404-355-1322
Mailing Address - Fax:404-355-5404
Practice Address - Street 1:1985 HOWELL MILL RD NW
Practice Address - Street 2:STE. B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2566
Practice Address - Country:US
Practice Address - Phone:404-355-1322
Practice Address - Fax:404-355-5404
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007617174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist