Organization
REVELLE PHYSICAL THERAPY
Active
Other names
Revelle Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MEEHAN PT, DPT, MTC (PHYSICAL THERAPY, OWNER)
(478) 954-9311
Entity
Organization
Contact information
Practice address
5502 PEACHTREE RD STE 100, CHAMBLEE, GA 30341-2310
(770) 800-2377
Mailing address
5502 PEACHTREE RD STE 100, CHAMBLEE, GA 30341-2314
(478) 954-9311
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053651026
NPI
—
01
—
1225661184
NPI
—
01
—
1255745592
NPI
—
01
—
1477007342
NPI
—
01
—
1568611986
NPI
—
01
—
1588059380
NPI
GA
01
—
1730598863
NPI
—
Enumeration date
09/22/2020
Last updated
09/10/2022
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