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General NPI Number Information
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NPI Number | 1881010171
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Entity Type | Organization
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Legal Business Name | JONESBORO REHAB & MASSAGE
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 284 N MAIN ST
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City | JONESBORO
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State | GA
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Zip | 30236-3267
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Country | US
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Telephone | 678-604-7799
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Fax | 678-604-7796
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Provider Business Mailing Address
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Address Line | 284 N MAIN ST
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City | JONESBORO
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State | GA
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Zip | 30236-3267
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Country | US
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Telephone | 678-604-7799
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Fax | 678-604-7796
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Authorized Official
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Title or Position | OWNER
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Name | MS. EURANIA PRINCETTE NORTON
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Credential |
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Telephone | 678-604-7799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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