Provider Demographics
NPI:1902099542
Name:DAVIS, ALBRADELLA REGINA (PT)
Entity type:Individual
Prefix:MRS
First Name:ALBRADELLA
Middle Name:REGINA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT
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Other - Credentials:
Mailing Address - Street 1:4578 HOLSTEIN HILL DR
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1380
Mailing Address - Country:US
Mailing Address - Phone:770-838-4059
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:770-840-8146
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT001622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist