Genesis Sports Medicine And Rehabilitation, LLC
Clinic/Center, Physical Therapy in Atlanta, GA. Organization (NPI-2).
NPI number1861600520
StatusActive
Last updated in NPPESJul 22, 2010
Details
- NPI
- 1861600520
- Entity type
- Organization (NPI-2)
- Legal business name
- Genesis Sports Medicine And Rehabilitation, LLC
- Organization subpart
- No
- Enumeration date
- May 18, 2007
- Last updated
- Jul 22, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2000X | Clinic/Center, Physical Therapy | PT006133 | GA | Yes |
Practice location
3890 Redwine Rd SwAtlanta, GA 30331-5582
Phone 404-344-7880 · Fax 404-344-7881
Mailing address
3890 Redwine Rd SwSuite 114
Atlanta, GA 30331-5582
Phone 404-344-7880 · Fax 404-344-7881
Authorized official
Kurt Anthony McDonald
President
4042901700
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