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General NPI Number Information
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NPI Number | 1215610381
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Entity Type | Organization
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Legal Business Name | PEACHTREE CENTER REHAB MEDICAL SERVICES
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 241 PEACHTREE ST NE STE B
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City | ATLANTA
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State | GA
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Zip | 30303-1421
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Country | US
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Telephone | 404-522-9991
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Fax | 404-522-9890
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Provider Business Mailing Address
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Address Line | 241 PEACHTREE ST NE STE B
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City | ATLANTA
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State | GA
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Zip | 30303-1421
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Country | US
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Telephone | 404-522-9991
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Fax | 404-522-9890
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Authorized Official
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Title or Position | PROPRIETOR
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Name | CARMEN F FLORES
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Credential | DC
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Telephone | 404-522-9991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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