# ACTIVE CARE MEDICAL ASSOCIATES OF FOREST PARK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427265495
- **Authorized official:** MRS. JENNIFER DANIELLE CRAWFORD (OFFICE MANAGER)
- **Authorized official phone:** (404) 366-4124

## Contact information

- **Practice address:** 1075 MAIN STREET, FOREST PARK, GA 30297
- **Practice address phone:** (404) 366-4124
- **Practice address fax:** (404) 366-0297
- **Mailing address:** \#342 5656 JONESBORO ROAD, SUITE \#111, LAKE CITY, GA 30260
- **Mailing address phone:** (404) 366-4124
- **Mailing address fax:** (404) 366-0297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251S0007X | Sports Physical Therapist | — | GA | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 08/22/2020