Organization
SUTHERLAND PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE JENNIFER SUTHERLAND PT (PHYSICAL THERAPIST)
(229) 292-7426
Entity
Organization
Contact information
Practice address
5108 NORTHWIND BLVD, VALDOSTA, GA 31605-7672
(229) 244-1201
(229) 244-1207
Mailing address
5108 NORTHWIND BLVD, VALDOSTA, GA 31605-7672
(229) 244-1201
(229) 244-1207
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT007469
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000957635C
—
GA
Enumeration date
12/28/2006
Last updated
10/02/2015
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