Provider Demographics
NPI:1497035489
Name:BODY MECHANICS REHABILITATION SERVICES, LLC
Entity Type:Organization
Organization Name:BODY MECHANICS REHABILITATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHABILITATION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNBUCKLE
Authorized Official - Suffix:
Authorized Official - Credentials:LP/OT
Authorized Official - Phone:678-458-6793
Mailing Address - Street 1:524 NEW RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-4153
Mailing Address - Country:US
Mailing Address - Phone:678-458-6793
Mailing Address - Fax:
Practice Address - Street 1:524 NEW RIVER WAY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-4153
Practice Address - Country:US
Practice Address - Phone:678-458-6793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2225273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit