Organization
ISLAND REHAB LLC
Active
Organization
ISLAND REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH PHILIP PICKAVANCE COTA (PARTNER)
(404) 232-0300
Entity
Organization
Contact information
Practice address
3711 SUWANEE CREEK CT, SUWANEE, GA 30024-2435
(770) 317-5512
Mailing address
3711 SUWANEE CREEK CT, SUWANEE, GA 30024-2435
(770) 317-5512
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
0000003767
GA
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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