# GEORGIA GERIATRICS AND REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972092955
- **Authorized official:** MR. WILLIE DAVID BEAVERS III PT, DPT, GCS (OWNER)
- **Authorized official phone:** (404) 438-7445

## Contact information

- **Practice address:** 549 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-6347
- **Practice address phone:** (404) 438-7445
- **Mailing address:** 549 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-6347

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251G0304X | Geriatric Physical Therapist | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |

## Other

- **Enumeration date:** 05/06/2018
- **Last updated:** 11/07/2023