Healthcare Provider Details
I. General information
NPI: 1609077833
Provider Name (Legal Business Name): ONSITE REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2007
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1715 HOWELL MILL RD NW SUITE B2
ATLANTA GA
30318-3167
US
IV. Provider business mailing address
1266 W PACES FERRY RD NW # 676
ATLANTA GA
30327-2306
US
V. Phone/Fax
- Phone: 404-351-5432
- Fax: 404-352-1917
- Phone: 404-351-5432
- Fax: 770-937-9131
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 000912 |
| License Number State | GA |
VIII. Authorized Official
Name: MRS.
JANICE
W
BRAUNSTEIN
Title or Position: PRESIDENT
Credential: PT
Phone: 404-351-5432