Provider Demographics
NPI:1053532820
Name:KWAKUMEY, ALOYSIUS KWABLA (MSPT, PHD)
Entity type:Individual
Prefix:DR
First Name:ALOYSIUS
Middle Name:KWABLA
Last Name:KWAKUMEY
Suffix:
Gender:M
Credentials:MSPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 LARKSHYRE TRAIL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043
Mailing Address - Country:US
Mailing Address - Phone:678-377-7009
Mailing Address - Fax:770-755-5682
Practice Address - Street 1:368 WEST PIKE STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045
Practice Address - Country:US
Practice Address - Phone:877-840-7372
Practice Address - Fax:770-755-5682
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT 005865225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist