Organization
GEORGIA TECH SPORTS MEDICINE AND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLIE RIDGEWAY BS, PT (PHYSICAL THERAPIST CLINIC DIRECTOR)
(404) 385-4115
Entity
Organization
Contact information
Practice address
150 BOBBY DODD WAY, ATLANTA, GA 30332-0001
(404) 385-4115
(404) 894-0695
Mailing address
150 BOBBY DODD WAY, ATLANTA, GA 30332-0001
(404) 385-4115
(404) 894-0695
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6601
GA
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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