Peach State Providers Group INC

NPI #1629111802 in Morrow, Georgia

Provider Information

NPI Number
1629111802
Entity Type
Organization
Organization Name
Peach State Providers Group INC
Primary Specialty
Physical Therapist
Enumeration Date
Feb 15, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
7146 SOUTHLAKE PARKWAY
City
Morrow
State
Georgia
ZIP Code
30260
Phone
(770) 960-9979

Authorized Official

Name
MRS. BRENDA R TALLEY, RPT
Title
PHYSICAL THERAPIST
Phone
(770) 960-9979

Specialties & Taxonomy Codes

Specialty
Physical Therapist

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