Organization
MIDDLE GA ORTHOPEADIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN THARPE COTA, CEAS, CFCE (FUNCTIONAL CAPACITY EVALUATOR)
(478) 953-7556
Entity
Organization
Contact information
Practice address
3051 WATSON BLVD STE 400, WARNER ROBINS, GA 31093-8556
(478) 953-7556
Mailing address
3370 ROSA CT, MACON, GA 31216-6737
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
000450
GA
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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