OrganizationActive
Therapy Medical-Wellness Centers, LLC
NPI 1124142013 · Physical Therapy Clinic/Center · Lawrenceville, GA
Provider details
- NPI number
- 1124142013
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Aloysius Kwakumey, Manager - Clinical Director(770) 755-5278
- License
- PT005865 (GA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
368 W Pike St
Suite 204
Lawrenceville, GA 30045-3240
Phone: (770) 755-5278
Fax: (770) 755-5682
Street-level locationGet directions
Mailing address
368 W Pike St
Lawrenceville, GA 30045-3240
Registry dates
- Enumerated
- 2007-03-18
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.