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Organization
SOUTH GEORGIA THERAPY SERVICES, P.C.
Active
Organization
SOUTH GEORGIA THERAPY SERVICES, P.C.
Active
Other names
Kenneth L. Durrence, P.T.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH LANE DURRENCE P.T. (OWNER/P.T.)
(912) 654-2385
Entity
Organization
Contact information
Practice address
104 W RUSTIN ST, GLENNVILLE, GA 30427-1805
(912) 654-2385
(912) 654-2394
Mailing address
104 W RUSTIN ST, GLENNVILLE, GA 30427-1805
(912) 654-2385
(912) 654-2394
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161037534A
—
GA
Enumeration date
07/17/2008
Last updated
07/29/2008
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