Provider Demographics
NPI:1750773842
Name:SYNERGIZE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:SYNERGIZE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PREWITT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:404-432-7222
Mailing Address - Street 1:1617 FERNSTONE DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-3572
Mailing Address - Country:US
Mailing Address - Phone:404-432-7550
Mailing Address - Fax:770-428-1268
Practice Address - Street 1:1617 FERNSTONE DR NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-3572
Practice Address - Country:US
Practice Address - Phone:404-432-7550
Practice Address - Fax:770-428-1268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003664225X00000X
GAPT009713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty