# BIG GYM THERAPY, LLC

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

## Provider details

- **NPI number:** 1710322706
- **Authorized official:** RENEE ROBERTSON MADDUX P.T. (MEMBER)
- **Authorized official phone:** (678) 736-0724

## Contact information

- **Practice address:** 4005 CANTON RD, MARIETTA, GA 30066-2739
- **Practice address phone:** (770) 728-8833
- **Practice address fax:** (678) 668-7469
- **Mailing address:** 4005 CANTON RD, MARIETTA, GA 30066-2739
- **Mailing address phone:** (770) 728-8833
- **Mailing address fax:** (678) 668-7469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | Yes |
| 2251P0200X | Pediatric Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 225XP0200X | Pediatric Occupational Therapist | — | NULL | — |
| 225XP0200X | Pediatric Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 05/03/2013
- **Last updated:** 07/23/2025