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Organization

ADVANCE REHABILITATION AND CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIM D SORRELLS (CREDENTIALING COORDINATOR)
(706) 236-2774
Entity
Organization

Contact information

Practice address
519 BROAD STREET, STE 300, ROME, GA 30161
(706) 802-1991
(706) 802-1408
Mailing address
PO BOX 949, ROME, GA 30162
(706) 802-1991
(706) 802-1408

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
225100000X
Physical Therapist
Primary
2251E1300X
Clinical Electrophysiology Physical Therapist
225200000X
Physical Therapy Assistant
2255A2300X
Athletic Trainer
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
09/12/2005
Last updated
09/26/2011
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