Organization
ATHLETES' POTENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL MATTA PT, DPT, OCS, CSCS (OWNER, PRESIDENT)
(478) 456-2149
Entity
Organization
Contact information
Practice address
1730 TAYLOR ST NW, ATLANTA, GA 30318-3742
(478) 456-2149
Mailing address
1048 WOODLAND AVE SE, ATLANTA, GA 30316-2512
(478) 456-2149
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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