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General NPI Number Information
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NPI Number | 1922513308
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Entity Type | Organization
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Legal Business Name | ATRIUM REHABILITATION AND WELLNESS
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 5112 ABERCORN AVE
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City | ATLANTA
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State | GA
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Zip | 30346-1625
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Country | US
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Telephone | 404-587-9907
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 468012
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City | ATLANTA
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State | GA
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Zip | 31146-8012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA STEPHENS
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Credential | OTR
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Telephone | 404-587-9907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 004194
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License Number State | GA
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