Big Gym Therapy, LLC
Physical Therapist, Pediatrics in Marietta, GA. Organization (NPI-2).
NPI number1710322706
StatusActive
Last updated in NPPESJul 23, 2025
Details
- NPI
- 1710322706
- Entity type
- Organization (NPI-2)
- Legal business name
- Big Gym Therapy, LLC
- Organization subpart
- No
- Enumeration date
- May 3, 2013
- Certification date
- Jul 23, 2025
- Last updated
- Jul 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251P0200X | Physical Therapist, Pediatrics | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 225X00000X | Occupational Therapist | – | – | |
| 225XP0200X | Occupational Therapist, Pediatrics | – | – |
Practice location
4005 Canton RdMarietta, GA 30066-2739
Phone 770-728-8833 · Fax 678-668-7469
Mailing address
4005 Canton RdMarietta, GA 30066-2739
Phone 770-728-8833 · Fax 678-668-7469
Authorized official
Renee Robertson Maddux
Member
6787360724
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