Provider Demographics
NPI:1720199458
Name:BONE REHABILITATION, INC.
Entity Type:Organization
Organization Name:BONE REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:706-321-9000
Mailing Address - Street 1:3151 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-5618
Mailing Address - Country:US
Mailing Address - Phone:706-321-9000
Mailing Address - Fax:706-321-9001
Practice Address - Street 1:3151 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-5618
Practice Address - Country:US
Practice Address - Phone:706-321-9000
Practice Address - Fax:706-321-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
116836Medicare Oscar/Certification