Provider Demographics
NPI:1043078652
Name:TENSEGRITY REHABILITATION INC
Entity Type:Organization
Organization Name:TENSEGRITY REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:770-568-7118
Mailing Address - Street 1:56 STRICKLAND DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1844
Mailing Address - Country:US
Mailing Address - Phone:770-568-7118
Mailing Address - Fax:
Practice Address - Street 1:1675 CUMBERLAND PKWY SE STE 202
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6360
Practice Address - Country:US
Practice Address - Phone:678-842-3767
Practice Address - Fax:678-284-2744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy