# DRMICHAELWANGPT, LLC

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

## Provider details

- **NPI number:** 1922680354
- **Authorized official:** MICHAEL WANG PT, DPT (PHYSICAL THERAPIST)
- **Authorized official phone:** (678) 388-9504

## Contact information

- **Practice address:** 4870 PEACHTREE INDUSTRIAL BLVD STE 600, BERKELEY LAKE, GA 30071-5734
- **Practice address phone:** (678) 388-9504
- **Practice address fax:** (404) 777-3474
- **Mailing address:** 4870 PEACHTREE INDUSTRIAL BLVD STE 600, BERKELEY LAKE, GA 30071-5734
- **Mailing address phone:** (678) 388-9504
- **Mailing address fax:** (404) 777-3474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2021
- **Last updated:** 04/26/2021