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General NPI Number Information
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NPI Number | 1104224641
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Entity Type | Organization
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Legal Business Name | ATLANTA REHABILITATION PHYSICIANS, P.C.
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 11775 POINTE PL SUITE 103
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City | ROSWELL
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State | GA
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Zip | 30076-4655
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Country | US
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Telephone | 770-619-0010
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Fax | 770-664-6511
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Provider Business Mailing Address
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Address Line | 1245 LEGEND RUN
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City | ALPHARETTA
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State | GA
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Zip | 30005-2282
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Country | US
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Telephone | 770-402-1845
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. BRENT ANTHONY CLOWER
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Credential | D.O.
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Telephone | 770-402-1845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | GA
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