Provider Demographics
NPI:1386941391
Name:JAYAN, ARCHANA (BPT)
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:
Last Name:JAYAN
Suffix:
Gender:F
Credentials:BPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5245 BUFORD HWY
Mailing Address - Street 2:STE 103/104
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2654
Mailing Address - Country:US
Mailing Address - Phone:770-449-5152
Mailing Address - Fax:770-449-5154
Practice Address - Street 1:5245 BUFORD HWY
Practice Address - Street 2:STE 103/104
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2654
Practice Address - Country:US
Practice Address - Phone:770-449-5152
Practice Address - Fax:770-449-5154
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT0101842251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic