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General NPI Number Information
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NPI Number | 1821262577
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL REHAB SERVICES
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 815 WALDEN GLEN LN
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City | EVANS
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State | GA
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Zip | 30809-3144
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Country | US
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Telephone | 706-495-2528
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Fax | 706-364-2518
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Provider Business Mailing Address
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Address Line | 815 WALDEN GLEN LN
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City | EVANS
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State | GA
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Zip | 30809-3144
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Country | US
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Telephone | 706-495-2528
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Fax | 706-364-2518
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Authorized Official
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Title or Position | OWNER
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Name | MS. MELINDA L COLEMAN
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Credential | OTR/L
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Telephone | 706-495-2528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT005606
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT003551
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License Number State | GA
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