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Organization
ACTIVE LIFE HEALTH OF LILBURN LLC
Active
Organization
ACTIVE LIFE HEALTH OF LILBURN LLC
Active
Other names
ARTHRITIS KNEE PAIN CENTERS
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J RUSH MD (CHAIRMAN & CHIEF EXECUTIVE OFFICER)
(770) 755-1515
Entity
Organization
Contact information
Practice address
629 BEAVER RUIN RD NW STE B, LILBURN, GA 30047-3437
(770) 755-1515
(770) 370-8173
Mailing address
629 BEAVER RUIN RD NW STE B, LILBURN, GA 30047-3437
(770) 755-1515
(770) 370-8173
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
11/09/2021
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