Provider Demographics
NPI:1427347103
Name:SILVERNAIL, PATRICIA E (PTA)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:E
Last Name:SILVERNAIL
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 1:571 DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-3208
Mailing Address - Country:US
Mailing Address - Phone:706-424-0882
Mailing Address - Fax:
Practice Address - Street 1:1865 BOLD SPRINGS RD NW
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30656-4605
Practice Address - Country:US
Practice Address - Phone:770-267-8677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA002565225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant