Provider Demographics
NPI:1992735419
Name:WESTBROOK, JOHN W (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:WESTBROOK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 TOWER RD NE STE 100
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-9403
Mailing Address - Country:US
Mailing Address - Phone:770-499-9918
Mailing Address - Fax:770-792-8276
Practice Address - Street 1:1505 STONE BRIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189
Practice Address - Country:US
Practice Address - Phone:770-926-6520
Practice Address - Fax:770-926-1359
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT4392225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist