Organization
CUSTOMIZED PHYSICAL THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDE REGGIE VELEZ PT (CEO)
(770) 485-2109
Entity
Organization
Contact information
Practice address
1398 VICTORIA ST, DOUGLASVILLE, GA 30134-2661
(770) 485-2109
(770) 485-2109
Mailing address
1398 VICTORIA ST, DOUGLASVILLE, GA 30134-2661
(770) 485-2109
(770) 485-2109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008600
GA
Other
Enumeration date
02/12/2010
Last updated
03/05/2010
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