Provider Demographics
NPI:1053173146
Name:CALHOUN PHYSICAL THERAPY
Entity type:Organization
Organization Name:CALHOUN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:678-614-2108
Mailing Address - Street 1:3560 CARL MOON RD NW
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30656-4318
Mailing Address - Country:US
Mailing Address - Phone:678-614-2108
Mailing Address - Fax:706-995-6839
Practice Address - Street 1:3560 CARL MOON RD NW
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30656-4318
Practice Address - Country:US
Practice Address - Phone:678-614-2108
Practice Address - Fax:706-995-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy