Healthcare Provider Details

I. General information

NPI: 1407121783
Provider Name (Legal Business Name): ADVANCE REHABILITATION & CONSULTING LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4204 CORAL PARK DR
BRUNSWICK GA
31520-3016
US

IV. Provider business mailing address

PO BOX 949
ROME GA
30162-0949
US

V. Phone/Fax

Practice location:
  • Phone: 912-280-9205
  • Fax: 912-280-0022
Mailing address:
  • Phone:
  • Fax:

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: RICHARD BINSTEIN
Title or Position: VP, AUTHORIZED OFFICIAL
Credential:
Phone: 713-297-7000