Provider Demographics
NPI:1962727719
Name:STABILITY PILATES AND PHYSICAL THERAPY OF ATLANTA LLC
Entity type:Organization
Organization Name:STABILITY PILATES AND PHYSICAL THERAPY OF ATLANTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONCAR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT, OCS, CERT MD
Authorized Official - Phone:404-303-9153
Mailing Address - Street 1:5975 ROSWELL RD NE STE C-333
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4048
Mailing Address - Country:US
Mailing Address - Phone:404-303-9153
Mailing Address - Fax:770-451-8304
Practice Address - Street 1:5975 ROSWELL RD NE STE C-333
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4048
Practice Address - Country:US
Practice Address - Phone:404-303-9153
Practice Address - Fax:770-451-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
GA6650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherEIN