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1610 Lavista Rd Ne Ste 9, Atlanta, GA 30329-4316 | |
(678) 671-6114 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 1610 Lavista Rd Ne Ste 9, Atlanta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1679199459 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2251X0800X | Physical Therapist - Orthopedic | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Erica Lynn Silverman Hosken |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1326335027 PECOS PAC ID: 1759552714 Enrollment ID: I20110922000675 |
Provider Name | Laura Glazebrook |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1942556295 PECOS PAC ID: 6002157781 Enrollment ID: I20190405001101 |
Provider Name | Andrew Thomas Modi |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1326658220 PECOS PAC ID: 2163849910 Enrollment ID: I20200825003791 |
Mailing Address | Practice Location Address |
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1610 Lavista Rd Ne Ste 9, Atlanta, GA 30329-4316 Ph: (678) 671-6114 | 1610 Lavista Rd Ne Ste 9, Atlanta, GA 30329-4316 Ph: (678) 671-6114 |