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NPI Code Detail

MEDICARE: MR. PAUL I RAY PT-ECS

MEDICARE: MR. PAUL I RAY PT-ECS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistPT003630GA
2225100000XPhysical TherapistPT003630GA
32251E1300XClinical Electrophysiology Physical Therapist

General Provider Information

NPI Number : 1578500609
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL I RAY PT-ECS
Provider Business Mailing Address
First Line : 210 E. DERENNE AVE
Second Line :
City : SAVANNAH
State : GA
Zip : 31405
Country : US
Telephone Number : 912-644-5300
Fax Number : 912-644-3369
Provider Business Practice Location Address
First Line : 247 S MAIN ST
Second Line :
City : REIDSVILLE
State : GA
Zip : 30453-4605
Country : US
Telephone Number : 912-557-1000
Fax Number : 912-644-3369
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 02/19/2013

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Directions to “ MR. PAUL I RAY PT-ECS” Practice Location

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