Organization
SOUTHERN CRESCENT PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA SUE THERIAC (OFFICE MANAGER)
(770) 716-9121
Entity
Organization
Contact information
Practice address
155 CARNEGIE PL, FAYETTEVILLE, GA 30214-3981
(770) 716-9121
(770) 716-2474
Mailing address
155 CARNEGIE PL, FAYETTEVILLE, GA 30214-3981
(770) 716-9121
(770) 716-2474
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
002989
GA
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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