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Contact Information

PHYSICALLY EMPOWERED THERAPY & WELLNESS
2300 SUGARLEAF TRAIL
HAMPTON, GA30228
 Phone: 770-203-5144
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for PHYSICALLY EMPOWERED THERAPY WELLNESS · (Female)

NPI # 1114215233
Status Active
Credentials
Entity Individual
Enumeration date 07/11/2011
Last updated 08/01/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # AT001665
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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