Organization
CORNERSTONE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH JAMES WHITLOW PT (PHYSICAL THERAPIST/ OWNER)
(706) 216-7910
Entity
Organization
Contact information
Practice address
54 LUMPKIN CAMPGROUND RD S, SUITE 100, DAWSONVILLE, GA 30534-6196
(706) 216-7910
(706) 216-7909
Mailing address
54 LUMPKIN CAMPGROUND RD S, SUITE 100, DAWSONVILLE, GA 30534-6196
(706) 216-7910
(706) 216-7909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004873
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000762187D
—
GA
01
—
1417006826
INDIVIDUAL NPI
GA
Enumeration date
02/15/2011
Last updated
02/15/2011
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