Most Relevant Information
Provider Data
| NPI Number: | 1003591744 |
| Provider Name: | JIBIN KOYIKKATHU TITUS DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/20/2023 |
| Last Updated: | 07/05/2023 |
Provider Practice Location
966A KILLIAN HILL RD SW
LILBURN
GA
300473102
Practice Location Phone/Fax
| Phone: | 7709234815 |
| Fax: |
Provider Mailing Location
512 KENION FOREST WAY
LILBURN
GA
300478809
Provider Mailing Phone/Fax
| Phone: | 7708466439 |
| Fax: |