Provider Demographics
NPI:1972926590
Name:ONCOLOGY REHAB, LLC
Entity Type:Organization
Organization Name:ONCOLOGY REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:KENDALL
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:423-202-2468
Mailing Address - Street 1:138 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6684
Mailing Address - Country:US
Mailing Address - Phone:423-202-2468
Mailing Address - Fax:
Practice Address - Street 1:138 KNOB HILL DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6684
Practice Address - Country:US
Practice Address - Phone:423-202-2468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty