Organization
IN HOME REHAB GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY BIGA (OWNER)
(770) 973-2207
Entity
Organization
Contact information
Practice address
3053 INTREPID CLOSE, MARIETTA, GA 30062-6603
(770) 973-2207
Mailing address
3053 INTREPID CLOSE, MARIETTA, GA 30062-6603
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1678
GA
225X00000X
Occupational Therapist
OT003837
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51101008-00
BLUE CROSS BLUE SHIELD GA
GA
Enumeration date
07/30/2006
Last updated
10/08/2007
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