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Organization
SOUTHERN WELLNESS & REHAB
Active
Organization
SOUTHERN WELLNESS & REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE BENNETT SMITH (PRACTICE MANAGER)
(912) 764-9951
Entity
Organization
Contact information
Practice address
601 BRANNEN ST, STATESBORO, GA 30458-2002
(912) 764-9951
(912) 489-4808
Mailing address
PO BOX 961, STATESBORO, GA 30459-0961
(912) 764-9951
(912) 489-4808
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT006880
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10052983
AMERIGROUP
GA
05
—
843784326A
—
GA
Enumeration date
01/19/2007
Last updated
05/21/2026
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