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Organization
REHABILITATION SERVICES OF COFFEE, INC
Active
Organization
REHABILITATION SERVICES OF COFFEE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD GARY ADAMS OTR/L, CHT (OCCUPATIONAL THERAPIST/OWNER)
(912) 383-0559
Entity
Organization
Contact information
Practice address
808 WARD ST W, DOUGLAS, GA 31533-3514
(912) 383-0559
(912) 383-0614
Mailing address
PO BOX 2150, TIFTON, GA 31793-2150
(912) 383-0559
(912) 383-0614
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
GA
225X00000X
Occupational Therapist
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031614A
—
GA
01
—
DA1122
RR MEDICARE
GA
Enumeration date
08/30/2006
Last updated
09/07/2010
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