Provider Demographics
NPI:1174074777
Name:AVERY PARTNERS, INC
Entity type:Organization
Organization Name:AVERY PARTNERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OUTPATIENT SERVICES
Authorized Official - Prefix:MISS
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIVES
Authorized Official - Suffix:IV
Authorized Official - Credentials:PT
Authorized Official - Phone:859-585-3002
Mailing Address - Street 1:1805 OLD ALABAMA RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2259
Mailing Address - Country:US
Mailing Address - Phone:770-642-6100
Mailing Address - Fax:678-367-4603
Practice Address - Street 1:1715 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3633
Practice Address - Country:US
Practice Address - Phone:478-742-0904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy