Organization
IN-HOME PHYSICAL THERAPY
Active
Organization
IN-HOME PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA SHEILA LAJA CAMPANANO DPT, WCC, CI (PT)
(770) 601-8984
Entity
Organization
Contact information
Practice address
1128 HARVEST BROOK DR, LAWRENCEVILLE, GA 30043-4743
(770) 601-8984
(770) 574-4428
Mailing address
1128 HARVEST BROOK DR, LAWRENCEVILLE, GA 30043-4743
(770) 601-8984
(770) 574-4428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315889908A
—
GA
Enumeration date
06/24/2015
Last updated
08/11/2015
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