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NPI Code Detail

MEDICARE: REHAB OF MARIETTA

MEDICARE: REHAB OF MARIETTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT007889GA

General Provider Information

NPI Number : 1770706483
Entity Type Code : Organization
Provider Name (Legal Business Name) : REHAB OF MARIETTA
Provider Business Mailing Address
First Line : PO BOX 671872
Second Line :
City : MARIETTA
State : GA
Zip : 30006-1872
Country : US
Telephone Number : 770-795-0506
Fax Number : 770-795-0392
Provider Business Practice Location Address
First Line : 2727 CANTON ROAD
Second Line : SUITE # 520
City : MARIETTA
State : GA
Zip : 30066
Country : US
Telephone Number : 770-795-0506
Fax Number : 770-795-0392
Authorized Official
Title or Position : BILLING MANAGER
Name : MR. DANIEL LYNN MIDDLETON
Credential :
Telephone Number : 770-850-0857
Provider Enumeration Date : 04/11/2007
Last Update Date : 08/22/2020

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Directions to “REHAB OF MARIETTA ” Practice Location

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