Healthcare Provider Details

I. General information

NPI: 1811284011
Provider Name (Legal Business Name): SCHOLAR REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2011
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 FRANCES MEEKS WAY STE 5,7,8,9
RICHMOND HILL GA
31324-3983
US

IV. Provider business mailing address

128 FRANCES MEEKS WAY STE 5,7,8,9
RICHMOND HILL GA
31324-3983
US

V. Phone/Fax

Practice location:
  • Phone: 912-727-2321
  • Fax: 912-445-0059
Mailing address:
  • Phone: 912-727-2321
  • Fax: 912-445-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA002411
License Number StateGA

VIII. Authorized Official

Name: LAUREN SCHOLAR
Title or Position: OCUUPATIONAL THERAPIST, REGISTERED
Credential:
Phone: 912-727-2321