Provider Demographics
NPI:1528844909
Name:TRAN, LINDA (DPT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-5783
Mailing Address - Country:US
Mailing Address - Phone:404-935-2358
Mailing Address - Fax:
Practice Address - Street 1:4920 ROSWELL RD STE 36
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2636
Practice Address - Country:US
Practice Address - Phone:404-464-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-14
Deactivation Date:2023-09-01
Deactivation Code:
Reactivation Date:2023-09-14
Provider Licenses
StateLicense IDTaxonomies
GAPT016769225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist