Functional Vitality is a
Occupational Therapist based in Mansfield, Georgia. Functional Vitality is licensed to practice in * (Not Available) (license number ) and their current practice location is
680 Grandview Rd, Mansfield, Georgia. It can be reached at their office (for appointments etc.) via phone at
(678) 278-8348.
NPI number for Functional Vitality is 1336879741 and their current mailing address is 680 Grandview Rd, Mansfield, Georgia. Functional Vitality
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1336879741.
Healthcare Provider's Profile
| Full Name | Functional Vitality |
|---|
| Type | Facility |
|---|
| Speciality | Occupational Therapist |
|---|
| Location | 680 Grandview Rd, Mansfield, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1336879741
- Provider Enumeration Date: 06/16/2022
- Last Update Date: 06/16/2022
Medical Identifiers
Medical identifiers for Functional Vitality such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336879741 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Functional Vitality is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Functional Vitality
680 Grandview Rd,
Mansfield, GA 30055-2571
Ph: (470) 266-0623 | Functional Vitality
680 Grandview Rd,
Mansfield, GA 30055-2571
Ph: (678) 278-8348 |
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