Organization
GEORGIA TECH SPORTS MEDICINE AND REHAB
Active
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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