Healthcare Provider Details

I. General information

NPI: 1881170363
Provider Name (Legal Business Name): SYNERGY REHAB ATLANTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 S COBB DR SE STE 250
SMYRNA GA
30080-8504
US

IV. Provider business mailing address

3903 S COBB DR SE STE 250
SMYRNA GA
30080-8504
US

V. Phone/Fax

Practice location:
  • Phone: 770-434-8976
  • Fax: 877-671-0945
Mailing address:
  • Phone: 770-434-8976
  • Fax: 877-671-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: REMOND FRANCOIS WEINBERG
Title or Position: CEO
Credential: DC
Phone: 770-596-1445