Organization
PROVISION PHYSICAL THERAPY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENILLA BARNES PT,DPT (PHYSICAL THERAPIST)
(404) 692-1654
Entity
Organization
Contact information
Practice address
105 COMMERCE DR STE B, FAYETTEVILLE, GA 30214-7352
(404) 692-1654
Mailing address
105 COMMERCE DR STE B, FAYETTEVILLE, GA 30214-7352
(404) 692-1654
(404) 393-4044
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PT009550
GA
Other
Enumeration date
07/01/2017
Last updated
07/07/2017
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