Provider Demographics
NPI:1912988098
Name:INJURY PREVENTION & MANAGEMENT CONSULTING LLC
Entity type:Organization
Organization Name:INJURY PREVENTION & MANAGEMENT CONSULTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - PRINCIPLE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:YEAGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:404-966-9181
Mailing Address - Street 1:4514 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6202
Mailing Address - Country:US
Mailing Address - Phone:404-966-9181
Mailing Address - Fax:404-249-9111
Practice Address - Street 1:1 DUNWOODY PARK
Practice Address - Street 2:SUITE 121
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6202
Practice Address - Country:US
Practice Address - Phone:404-966-9181
Practice Address - Fax:770-394-4110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0057712251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty