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Organization
ONESOURCE OSTEOPRACTIC REHAB
Active
Organization
ONESOURCE OSTEOPRACTIC REHAB
Active
Other names
ONESOURCE SPORTS NEURO REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
COLLIN ADU DPT (CEO)
(678) 548-0879
Entity
Organization
Contact information
Practice address
367 ATHENS HWY STE 1100, LOGANVILLE, GA 30052-8256
(678) 250-4035
Mailing address
367 ATHENS HWY STE 1100, LOGANVILLE, GA 30052-8256
(678) 250-4037
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
Primary
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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