Provider Demographics
NPI:1003946013
Name:REMOBILITY, INC.
Entity Type:Organization
Organization Name:REMOBILITY, INC.
Other - Org Name:REMOBILITY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:N
Authorized Official - Middle Name:ROEL
Authorized Official - Last Name:FUNG-A-WING
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:770-578-4343
Mailing Address - Street 1:3901 ROSWELL RD.
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8811
Mailing Address - Country:US
Mailing Address - Phone:770-578-4343
Mailing Address - Fax:770-578-4342
Practice Address - Street 1:3901 ROSWELL RD
Practice Address - Street 2:SUITE 100A
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8811
Practice Address - Country:US
Practice Address - Phone:770-578-4343
Practice Address - Fax:770-578-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3341225100000X
GA74893225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAS95513Medicare UPIN
GA202G650030Medicare UPIN
GA65BBBGGMedicare ID - Type Unspecified