Organization
EAGLE PHYSICAL THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANUJ MASIH MPT (OWNER)
(404) 510-5007
Entity
Organization
Contact information
Practice address
1506 KLONDIKE RD SW, SUITE 202, CONYERS, GA 30094-5173
(404) 510-5007
Mailing address
1506 KLONDIKE RD SW, SUITE 202, CONYERS, GA 30094-5173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008482
GA
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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