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General NPI Number Information
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NPI Number | 1710045653
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Entity Type | Organization
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Legal Business Name | REHABILITACTICS, PC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 501 PULLIAM ST SW SUITE 144
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City | ATLANTA
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State | GA
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Zip | 30312-2755
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Country | US
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Telephone | 404-522-2422
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Fax | 404-242-2292
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Provider Business Mailing Address
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Address Line | PO BOX 2889
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City | DECATUR
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State | GA
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Zip | 30031-2889
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Country | US
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Telephone | 404-522-2422
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Fax | 404-522-2292
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHARRON L THOMPSON
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Credential | MD
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Telephone | 404-522-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 039965
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License Number State | GA
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