Organization
AGEWELL REHAB AND FITNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM IVEY JR. (ORGANIZER)
(404) 823-8157
Entity
Organization
Contact information
Practice address
4060 INVERNESS XING, ROSWELL, GA 30075-4781
(404) 823-8157
(888) 877-6415
Mailing address
4060 INVERNESS XING, ROSWELL, GA 30075-4781
(404) 823-8157
(888) 877-6415
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
PT005195
GA
Other
Enumeration date
02/03/2016
Last updated
12/15/2021
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