Physically Empowered Therapy & Wellness

NPI #1114215233 in Hampton, Georgia

Provider Information

NPI Number: 1114215233
Entity Type: Organization
Organization Name: Physically Empowered Therapy & Wellness
Primary Specialty: Specialist/Technologist - Athletic Trainer
Enumeration Date: Jul 11, 2011
Last Updated: Aug 1, 2018

Practice Location

Address: 2300 SUGARLEAF TRAIL
City: Hampton
State: Georgia
ZIP Code: 30228
Phone: (770) 203-5144

Authorized Official

Name: MR. JEANCARLO ALENCASTRO, ATC/L
Title: CLINIC OWNER
Phone: (770) 203-5144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X	Primary

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