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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DIAMOND MUNGROO

Active

DIAMOND MUNGROO is a Physical Therapy Assistant healthcare provider located in EAST ELLIJAY, Georgia. NPI 1871118505 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · EAST ELLIJAY, GA

Registration Details

NPI Number
1871118505
Provider Type
Individual
Gender
Female
NPI Issued
Jun 9, 2020 (6.1596611965806 yrs)
Last Updated
Jan 3, 2026
Licenses
AT004177 (GA)
PT017813 (GA)

Practice Information

Address
97 HEFNER ST
EAST ELLIJAY, GA, 305408268
Browse GA providers · Browse ZIP 30540
Phone
7066351440
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in EAST ELLIJAY, GA

Name Credential NPI
JUSTIN SHURLEY PT 1154325678
SHELBY LEE NIX OT 1801465810
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.