Organization
1SOURCE FITNESS & SPORTS NEURO REHAB
Active
Parent organization
1SOURCE FITNESS & SPORTS NEURO REHAB
Other names
1Source Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
1SOURCE FITNESS & SPORTS NEURO REHAB
Authorized official
COLLIN ADU DPT.GCS. MBA (CLINICAL DIRECTOR)
(678) 250-4035
Entity
Organization
Contact information
Practice address
4728 JOSEPH ELI DR, SNELLVILLE, GA 30039-7138
(678) 257-4037
(678) 257-4037
Mailing address
4728 JOSEPH ELI DR, SNELLVILLE, GA 30039-7138
(678) 257-4037
(678) 257-4037
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
12002969
GA
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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