Provider Demographics
NPI:1023827722
Name:ATHLETIC JOINT
Entity type:Organization
Organization Name:ATHLETIC JOINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HOOMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOURPARVAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:678-640-7392
Mailing Address - Street 1:2140 FEDERAL RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4185
Mailing Address - Country:US
Mailing Address - Phone:678-640-7392
Mailing Address - Fax:
Practice Address - Street 1:2140 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-4185
Practice Address - Country:US
Practice Address - Phone:678-640-7392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty