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Organization

DRMICHAELWANGPT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL WANG PT, DPT (PHYSICAL THERAPIST)
(678) 388-9504
Entity
Organization

Contact information

Practice address
4870 PEACHTREE INDUSTRIAL BLVD STE 600, BERKELEY LAKE, GA 30071-5734
(678) 388-9504
(404) 777-3474
Mailing address
4870 PEACHTREE INDUSTRIAL BLVD STE 600, BERKELEY LAKE, GA 30071-5734
(678) 388-9504
(404) 777-3474

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003190230B
GA
Enumeration date
04/26/2021
Last updated
04/26/2021
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