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General NPI Number Information
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NPI Number | 1386285153
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Entity Type | Organization
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Legal Business Name | RWW OUTPATIENT REHAB SERVICES, LLC
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 1860 ATKINSON RD STE 101
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5066
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Country | US
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Telephone | 678-442-7861
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40222-5186
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Country | US
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Telephone | 502-630-7249
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Fax |
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Authorized Official
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Title or Position | NATIONAL CREDENTIALING MANAGER
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Name | HEATHER WILSON
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Credential |
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Telephone | 502-272-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 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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