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Individual

GEORGE BRENT APPLEGATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
4371 POWERS FERRY RD, ATLANTA, GA 30327-3420
(678) 984-7774
(888) 551-6210
Mailing address
316 S WASHINGTON AVE, FORT COLLINS, CO 80521-2559
(678) 984-7774

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007063
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
148541482B
GA
01
52704274
BCBS OF GA PROVIDER ID
GA
Enumeration date
03/16/2007
Last updated
12/29/2016
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