MEDICARE: CONCENTRA HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QX0100X	Occupational Medicine Clinic/Center
3	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1770748618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCENTRA HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DRIVE
Second Line	:	SUITE 1200 WEST
City	:	ADDISON
State	:	TX
Zip	:	75001-4648
Country	:	US
Telephone Number	:	800-232-3550
Fax Number	:	214-775-4515

Provider Business Practice Location Address
First Line	:	4223 MORELAND AVE HWY 42
Second Line	:
City	:	CONLEY
State	:	GA
Zip	:	30288-2141
Country	:	US
Telephone Number	:	404-366-2900
Fax Number	:	404-366-2994

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEITH NEWTON
Credential	:
Telephone Number	:	972-364-8106

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	04/21/2009

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