| Ideal Therapy, Llc | |
|
290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | |
| (404) 994-7727 | |
| (404) 994-7728 |
| Full Name | Ideal Therapy, Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 290 Highway 314, Fayetteville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558508580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT008318 (Georgia) | Primary |
| Provider Name | Corlette Luke-cambridge |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841457900 PECOS PAC ID: 5698747657 Enrollment ID: I20090416000359 |
| Provider Name | Jessica Denise Williams |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1366970881 PECOS PAC ID: 5890065916 Enrollment ID: I20170724001425 |
| Provider Name | Marion B Tyson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538616305 PECOS PAC ID: 2567717564 Enrollment ID: I20180614002836 |
| Provider Name | Shanice Johndria Reeves |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861053464 PECOS PAC ID: 0840526604 Enrollment ID: I20190731003000 |
| Provider Name | Deshia Dees |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376293027 PECOS PAC ID: 2567840929 Enrollment ID: I20220526000958 |
| Provider Name | Danielle Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306352612 PECOS PAC ID: 7719234673 Enrollment ID: I20221206001799 |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Therapy, Llc 290 Highway 314, Fayetteville, GA 30214-7813 Ph: (404) 994-7727 | Ideal Therapy, Llc 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 Ph: (404) 994-7727 |
Mrs. Lisa Lajune Smith, PT, M.ED. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1255 Highway 54 W, Fayetteville, GA 30214 Phone: 770-719-7183 Fax: 770-719-7189 | |
Mr. Ryan Christopher Yolitz, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1265 Highway 54 W, Suite 103 And 308, Fayetteville, GA 30214 Phone: 770-460-1900 Fax: 770-719-1214 | |
Mrs. Harvelyn Duncan Smith, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1250 Highway 54 W, Fayetteville, GA 30214 Phone: 770-719-7290 | |
Francis O'rourke, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 565 Banks Rd E, Fayetteville, GA 30214 Phone: 770-875-8621 | |
Drayton Thomas Perkins, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1275 Highway 54 W, Ste 200, Fayetteville, GA 30214 Phone: 770-460-8609 Fax: 770-460-8629 | |
Sarah Grace Osborne, OT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1275 Highway 54 W Ste 200, Fayetteville, GA 30214 Phone: 770-460-8609 Fax: 770-460-8629 | |
Anne Marie Sheridan, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 560 Grady Ave Ste C, Fayetteville, GA 30214 Phone: 770-461-6488 Fax: 770-461-5861 |