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JEFFREY B GIDDENS PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1578569794

Individual Registrant:
 JEFFREY B GIDDENS PT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
106 PEARL DR SUITE 104 LA FAYETTE, GA 30728-7509 US
Tel: 706-638-3880  Fax: 706-638-3890

Contact information for business:
PO BOX 431  LA FAYETTE, GA 30728-0431 US
Tel: 706-638-3880  Fax: 706-638-3890

Registration Information:
NPI: 1578569794
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
ALPTH5116
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
GAPT006659

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RR MEDICAREP00853195GA01
000904648KGA05




HEALTH CARE JOBS GA - Page 1



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