Individual
BENJAMIN TIMOTHY MCAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
3450 COBB PKWY NW, SUITE 140, ACWORTH, GA 30101-8351
(770) 974-1978
(770) 974-1979
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6719
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427259008A
—
GA
01
—
808095
BCBS GA
GA
01
—
P00097956
RAILROAD MEDICARE
GA
Enumeration date
06/02/2006
Last updated
11/19/2010
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