Doctor Name: | SUSAN HARBISON MAYNE |
NPI Number: | 1013022417 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT002955 |
Business Practice Address: | 2217 Roswell Rd. Suite A100 Marietta, GA - 30062 |
Business Phone Number: | 7703216600 |
Business Fax Number: | 7703215559 |
Mailing Address: | 310 Technology Pkwy, NORCROSS |
State: | GA |
Postal Code: | 300922932 |
Phone Number: | 7704411580 |
Fax Number: | |
NPI Enumeration Date: | 08/19/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT002955 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |