Provider Demographics
NPI:1194124826
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/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAME
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MBA
Authorized Official - Phone:770-934-5712
Mailing Address - Street 1:2171 NORTHLAKE PKWY STE 118
Mailing Address - Street 2:
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:
Practice Address - Street 1:2171 NORTHLAKE PKWY STE 118
Practice Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT001091261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy