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General NPI Number Information
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NPI Number | 1447886320
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Entity Type | Organization
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Legal Business Name | MOMENTUM REHAB & THERAPY
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 5349 SNAPFINGER WOODS DR
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City | DECATUR
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State | GA
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Zip | 30035-4028
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Country | US
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Telephone | 470-375-7345
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Fax | 470-200-2768
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Provider Business Mailing Address
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Address Line | 5349 SNAPFINGER WOODS DR
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City | DECATUR
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State | GA
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Zip | 30035-4028
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Country | US
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Telephone | 470-375-7345
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Fax | 470-200-2768
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KIMBERLY STABLER
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Credential |
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Telephone | 470-375-7345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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