Healthcare Provider Details

I. General information

NPI: 1427693407
Provider Name (Legal Business Name): SHEPARD THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 GA HIGHWAY 32 BYP
ALMA GA
31510
US

IV. Provider business mailing address

139 GA HWY 32 BYPASS
ALMA GA
31510-1516
US

V. Phone/Fax

Practice location:
  • Phone: 912-632-6321
  • Fax: 912-632-6322
Mailing address:
  • Phone: 912-632-6321
  • Fax: 912-632-6322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH SHEPARD
Title or Position: OWNER
Credential:
Phone: 912-632-6321