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1457840290
FORM PHYSICAL THERAPY LLC
ROSWELL, GA
NPI
1457840290
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Entity Type
Organization
Authorized Contact
BLAIR HOLLIDAY
Owner
678-936-0821
Organization Subpart ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: GA PT008864)
Enumeration Date
2018-05-07
Last Update Date
2018-05-12
Business Address
FORM PHYSICAL THERAPY LLC
1295 HEMBREE RD STE A201
ROSWELL, GA 30076
Phone number: 678-936-0821
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Mailing Address
FORM PHYSICAL THERAPY LLC
4005 DOVER AVE
ALPHARETTA, GA 30009-3283
Phone number: 678-936-0821
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