Provider Demographics
NPI:1649517277
Name:ADVANCED REHAB PHYSICAL THERAPY & NON MEDICAL HOME CARE SVS INC..
Entity type:Organization
Organization Name:ADVANCED REHAB PHYSICAL THERAPY & NON MEDICAL HOME CARE SVS INC..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-273-6444
Mailing Address - Street 1:316 E 16TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-1209
Mailing Address - Country:US
Mailing Address - Phone:229-273-6444
Mailing Address - Fax:
Practice Address - Street 1:316 E 16TH AVE STE A
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-1209
Practice Address - Country:US
Practice Address - Phone:229-273-6444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty