Healthcare Provider Details

I. General information

NPI: 1609813989
Provider Name (Legal Business Name): HUMAN PERFORMANCE AND REHABILITATION CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6298 VETERANS PKWY SUITE 5A
COLUMBUS GA
31909-3526
US

IV. Provider business mailing address

PO BOX 8068
COLUMBUS GA
31908-8068
US

V. Phone/Fax

Practice location:
  • Phone: 706-324-3558
  • Fax: 706-320-5484
Mailing address:
  • Phone: 706-320-5461
  • 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 Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BRIAN S MC CLUSKEY
Title or Position: PRESIDENT/CEO
Credential: PH.D.
Phone: 706-322-7762