Organization
ANDRADA PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN BANADOS ANDRADA PT (PRESIDENT)
(478) 405-7010
Entity
Organization
Contact information
Practice address
3356 VINEVILLE AVE, STE C, MACON, GA 31204-2328
(478) 405-7010
(478) 405-7012
Mailing address
3356 VINEVILLE AVE, STE C, MACON, GA 31204-2328
(478) 405-7010
(478) 405-7012
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
4707
GA
Other
Enumeration date
10/25/2007
Last updated
01/10/2013
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