Organization
LUTHERSVILLE SPINAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AL KELLY (DIRECTOR)
(404) 991-9895
Entity
Organization
Contact information
Practice address
191 S MAIN ST, LUTHERSVILLE, GA 30251-1809
(404) 991-9895
Mailing address
191 S MAIN ST, LUTHERSVILLE, GA 30251-1809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032264
MEDICAL
GA
Enumeration date
05/30/2018
Last updated
05/30/2018
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