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Organization
GEORGIA GERIATRICS AND REHABILITATION
Active
Organization
GEORGIA GERIATRICS AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE DAVID BEAVERS III PT, DPT, GCS (OWNER)
(404) 438-7445
Entity
Organization
Contact information
Practice address
549 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-6347
(404) 438-7445
Mailing address
549 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-6347
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/06/2018
Last updated
11/07/2023
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