Organization
SOUTHERN PELVIC HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA REALE DPT (OWNER)
(719) 429-6371
Entity
Organization
Contact information
Practice address
601 WOODLAWN DR NE STE 100, MARIETTA, GA 30067-3504
(770) 415-4815
Mailing address
300 SOMERSET LN SE, MARIETTA, GA 30067-4310
(719) 429-6371
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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