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Contact Information

AGAPE SPORTS PERFORMANCE WELLNESS AND REHAB
402 BECKETT LANE
FAYETTEVILLE, GA30214
 Phone: 404-839-0841
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy

261QP2000X
Indicates primary specialty

NPI Profile & details for AGAPE SPORTS PERFORMANCE WELLNESS AND REHAB

NPI Number 1427218106
LBN Legal business name AGAPE SPORTS PERFORMANCE WELLNESS AND REHAB
Authorized official TOLA AKOMOLAFE - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/16/2008
Last updated 06/16/2008 - About 18 years ago
Identifiers
GA License # PT 04336
GA Other 166964592 NPPES/NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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