Healthcare Provider Details
I. General information
NPI: 1942465877
Provider Name (Legal Business Name): CONCENTRA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2008
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
688 SPRING STEET
ATLANTA GA
30308-1934
US
IV. Provider business mailing address
5080 SPECTRUM DRIVE SUITE 1200 WEST
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 404-881-1155
- Fax: 404-881-9875
- Phone: 800-232-3550
- Fax: 214-775-4515
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KEITH
NEWTON
Title or Position: PRESIDENT
Credential:
Phone: 972-364-8106