Georgia Sports Therapy and Rehabilitation

NPI #1912188962 in Dacula, Georgia

Provider Information

NPI Number: 1912188962
Entity Type: Organization
Organization Name: Georgia Sports Therapy and Rehabilitation
Primary Specialty: Physical Therapist
Enumeration Date: Nov 19, 2007
Last Updated: Nov 19, 2007

Practice Location

Address: 3511 BRASELTON HWY
Address 2: STE G-2
City: Dacula
State: Georgia
ZIP Code: 30019-5925
Phone: (770) 932-3212

Authorized Official

Name: MR. CHRISTOPHER JAMES MALLARE, M.S., P.T.
Title: CLINICAL DIRECTOR
Phone: (770) 932-3212

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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