Doctor Name: | TERESA BRISTOL |
NPI Number: | 1053381400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, CERT. DN |
License Number: | PT007043 |
Business Practice Address: | 1150 Us Highway 41 Nw Suite 3 Jasper, FL - 320525888 |
Business Phone Number: | 2292914275 |
Business Fax Number: | |
Mailing Address: | 400 W Peachtree St Nw, Unit 1909 ATLANTA |
State: | GA |
Postal Code: | 303083536 |
Phone Number: | 2292914275 |
Fax Number: | |
NPI Enumeration Date: | 01/26/2006 |
NPI Last Update Date: | 04/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | PT007043 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |