Doctor Name: | PATRICK DELISLE |
NPI Number: | 1528434206 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | PT003956 |
Business Practice Address: | 655 Molly Ln Suite 100 Woodstock, GA - 301896503 |
Business Phone Number: | 7705171080 |
Business Fax Number: | |
Mailing Address: | 655 Molly Ln, Suite 100 WOODSTOCK |
State: | GA |
Postal Code: | 301896503 |
Phone Number: | 7705171080 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2015 |
NPI Last Update Date: | 08/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT003956 |
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 |