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Organization
SOVEREIGN REHABILITATION OF GEORGIA, LLC
Active
Organization
SOVEREIGN REHABILITATION OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLETTE JOHNSON (VP OF OPERATIONS)
(404) 680-6470
Entity
Organization
Contact information
Practice address
1301 SIGMAN RD NE, SUITE 220, CONYERS, GA 30012-3812
(678) 210-0311
(678) 210-0335
Mailing address
1301 SIGMAN RD NE, SUITE 220, CONYERS, GA 30012-3812
(678) 210-0311
(678) 210-0335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008054
GA
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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