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General NPI Number Information
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NPI Number | 1053401190
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Entity Type | Organization
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Legal Business Name | OCONEE REHABILITATION SERVICES INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 446 SPRING STREET
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City | SPARTA
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State | GA
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Zip | 31087
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Country | US
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Telephone | 706-444-9200
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Fax | 706-444-9201
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Provider Business Mailing Address
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Address Line | PO BOX 454
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City | SPARTA
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State | GA
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Zip | 31087
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Country | US
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Telephone | 706-444-9200
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Fax | 706-444-9201
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONNA ANDREWS BENTON
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Credential | PT
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Telephone | 706-444-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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