Healthcare Provider Details

I. General information

NPI: 1407449168
Provider Name (Legal Business Name): INTEGRITY REHAB MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2021
Last Update Date: 03/19/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 STRICKLAND PASTURE RD
JACKSON GA
30233-4019
US

IV. Provider business mailing address

252 STRICKLAND PASTURE RD
JACKSON GA
30233-4019
US

V. Phone/Fax

Practice location:
  • Phone: 706-329-5108
  • Fax:
Mailing address:
  • Phone: 706-329-5108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHAWN HUMPHRIES
Title or Position: OWNER-MANAGER
Credential: MPT, OCS, ECS
Phone: 706-329-5108