Organization
TRIDENT PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY STANFORD DPT (OWNER)
(770) 910-7227
Entity
Organization
Contact information
Practice address
248 E CROGAN ST STE 5, LAWRENCEVILLE, GA 30046-5069
(770) 910-7227
Mailing address
248 E CROGAN ST STE 5, LAWRENCEVILLE, GA 30046-5069
(770) 910-7227
(470) 221-1514
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/22/2021
Last updated
07/14/2022
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