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General NPI Number Information
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NPI Number | 1922409341
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Entity Type | Organization
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Legal Business Name | SUPERIOR HEALTHCARE OF BELLS FERRY, LLC
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Dates
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Enumeration Date | 09/05/2014
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 5505 BELLS FERRY RD
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City | ACWORTH
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State | GA
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Zip | 30102-7527
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Country | US
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Telephone | 770-310-2204
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Fax |
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Provider Business Mailing Address
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Address Line | 5505 BELLS FERRY RD
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City | ACWORTH
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State | GA
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Zip | 30102-7527
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Country | US
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Telephone | 770-310-2204
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS HOURIN
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Credential | D.C.
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Telephone | 770-310-2204
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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 | LC20140000672
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License Number State | GA
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