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Organization
PT WORKS LLC
Active
Organization
PT WORKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA BRISTOL PT, CERT. DN, DPT (CEO)
(470) 733-2135
Entity
Organization
Contact information
Practice address
1100 PEACHTREE ST NE STE 250, ATLANTA, GA 30309-4522
(470) 733-2135
Mailing address
400 W PEACHTREE ST NW UNIT 1909, ATLANTA, GA 30308-3551
(855) 703-9473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003190988A
—
GA
01
—
05207111
AMERIGROUP
GA
01
—
1053381400-001
TRICARE SOUTH
GA
01
—
4620664
CIGNA
—
Enumeration date
09/19/2019
Last updated
09/19/2019
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