Provider Demographics
NPI:1427724780
Name:DE JESUS FERREIRA ALVES, JULIANA (PT, MS)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:DE JESUS FERREIRA ALVES
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 NEESE FARM DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-1405
Mailing Address - Country:US
Mailing Address - Phone:404-425-0506
Mailing Address - Fax:
Practice Address - Street 1:3945 HOLCOMB BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-5200
Practice Address - Country:US
Practice Address - Phone:770-840-8045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist