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Organization
VITAL VILLAGE PHYSICAL THERAPY
Active
Organization
VITAL VILLAGE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN UNDERWOOD (OWNER)
(706) 994-2852
Entity
Organization
Contact information
Practice address
116 LOVE LN, WOODSTOCK, GA 30188-4281
(706) 994-2852
Mailing address
116 LOVE LN, WOODSTOCK, GA 30188-4281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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