Organization
ACTIVE CARE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY A COOLEY M.P.T. (PRESIDENT)
(678) 787-1436
Entity
Organization
Contact information
Practice address
6342 GRAND HICKORY DR, SUITE 102, BRASELTON, GA 30517-4015
(678) 787-1436
Mailing address
805 SUWANEE LAKES CIR, SUWANEE, GA 30024-3122
(678) 787-1436
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008084
GA
Other
Enumeration date
01/31/2007
Last updated
08/22/2020
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