FORM PHYSICAL THERAPY LLC

ROSWELL, GA
NPI1457840290
Entity TypeOrganization
Authorized ContactBLAIR HOLLIDAY
Owner
678-936-0821
Organization Subpart ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: GA  PT008864)
Enumeration Date2018-05-07
Last Update Date2018-05-12
Business Address
FORM PHYSICAL THERAPY LLC
1295 HEMBREE RD STE A201
ROSWELL, GA 30076
Phone number: 678-936-0821
Mailing Address
FORM PHYSICAL THERAPY LLC
4005 DOVER AVE
ALPHARETTA, GA 30009-3283
Phone number: 678-936-0821
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