Organization
NEUROMUSCULAR ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN HUBENY (OFFICE MANAGER/THERAPIST)
(404) 943-1053
Entity
Organization
Contact information
Practice address
275 CARPENTER DR NE, SUITE 307, ATLANTA, GA 30328-4928
(404) 943-1053
Mailing address
4911 HERITAGE TRACE CT, MARIETTA, GA 30062-6309
(678) 795-9835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT004390
GA
225700000X
Massage Therapist
MT004390
GA
226300000X
Kinesiotherapist
MT004390
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0582595253
FORTIS INSURANCE
—
01
—
127648551073
HUMANA INSURANCE
KY
01
—
253829370
UNITED HEALTHCARE
GA
01
—
508077
COVENTRY HEALTH CARE
GA
01
—
52673545
BLUE CROSS BLUE SHIELD
GA
01
—
582595253
CONNECTICUT GENERAL LIFE
—
Enumeration date
02/10/2008
Last updated
06/22/2008
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