Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | PT009464 | GA |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT009474 | GA |
NPI | 1073767216 |
---|---|
Provider Name | Margaret Mary Gebhardt |
First Address | Atlanta, GA 30307-5507 |
Second Address | Atlanta, GA 30305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2008 |
Last Update Date | 14/11/2008 |