Provider Demographics
NPI:1972750503
Name:ABOVE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:ABOVE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA-ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOVE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:770-904-2332
Mailing Address - Street 1:4411 SUWANEE DAM RD
Mailing Address - Street 2:SUITE #330
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8701
Mailing Address - Country:US
Mailing Address - Phone:770-904-2332
Mailing Address - Fax:
Practice Address - Street 1:4411 SUWANEE DAM RD
Practice Address - Street 2:SUITE #330
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8701
Practice Address - Country:US
Practice Address - Phone:770-904-2332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006440261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy