Organization
PROACTIVE PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA NICOLE FOWLER PT (OWNER/PT)
(404) 247-0174
Entity
Organization
Contact information
Practice address
4625 ALEXANDER DR, SUITE 115, ALPHARETTA, GA 30022-3719
(404) 247-0174
Mailing address
1360 BELLSMITH DR, ROSWELL, GA 30076-0915
(404) 247-0174
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT008404
GA
Other
Enumeration date
01/17/2009
Last updated
01/17/2009
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