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General NPI Number Information
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NPI Number | 1689845729
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Entity Type | Organization
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Legal Business Name | COR II
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 5555 PEACHTREE DUNWOODY RD NE SUITE 201
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City | ATLANTA
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State | GA
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Zip | 30342-1703
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Country | US
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Telephone | 404-835-3343
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 NORTHSIDE FORSYTH DRIVE SUITE 2400
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City | CUMMING
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State | GA
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Zip | 30041
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Country | US
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Telephone | 678-205-3124
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Fax | 678-205-3134
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Authorized Official
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Title or Position | SERVICE CENTER DIRECTOR
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Name | MRS. REBECCA DAWN HOLLAND
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Credential |
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Telephone | 404-835-3343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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