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Organization
MELTDOWN FITNESS ATLANTA, LLC
Active
Organization
MELTDOWN FITNESS ATLANTA, LLC
Active
Other names
Rehab and Beyond
Organization subpart
No
Provider details
NPI number
Authorized official
STANFORD JAMES MADDOX (OWNER)
(770) 899-6364
Entity
Organization
Contact information
Practice address
3983 LAVISTA RD STE 128, TUCKER, GA 30084-5151
(833) 887-3422
Mailing address
2250 OAK RD UNIT 815, SNELLVILLE, GA 30078-1905
(833) 887-3422
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
AETNA
—
Enumeration date
09/09/2020
Last updated
11/23/2021
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