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General NPI Number Information
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NPI Number | 1497035489
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Entity Type | Organization
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Legal Business Name | BODY MECHANICS REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 524 NEW RIVER WAY
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City | MCDONOUGH
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State | GA
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Zip | 30252-4153
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Country | US
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Telephone | 678-458-6793
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Fax |
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Provider Business Mailing Address
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Address Line | 524 NEW RIVER WAY
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City | MCDONOUGH
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State | GA
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Zip | 30252-4153
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Country | US
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Telephone | 678-458-6793
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Fax |
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Authorized Official
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Title or Position | REHABILITATION DIRECTOR
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Name | MR. OLIVER HORNBUCKLE
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Credential | LP/OT
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Telephone | 678-458-6793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 2225
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License Number State | GA
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