Healthcare Provider Details

I. General information

NPI: 1669555660
Provider Name (Legal Business Name): RHD HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5593 FORKWOOD DR NW
ACWORTH GA
30101-8011
US

IV. Provider business mailing address

5593 FORKWOOD DR NW
ACWORTH GA
30101-8011
US

V. Phone/Fax

Practice location:
  • Phone: 404-642-5497
  • Fax: 777-919-1752
Mailing address:
  • Phone: 404-642-5497
  • Fax: 777-919-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006310
License Number StateGA

VIII. Authorized Official

Name: MRS. TINA RIGDON
Title or Position: BILLING MANAGER
Credential:
Phone: 678-838-1585