Organization
WELLSPRING THERAPY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRAYSON GENTZEL MPT (ADMINISTRATOR)
(706) 348-2004
Entity
Organization
Contact information
Practice address
10 S BROOK ST, SUITE 2, CLEVELAND, GA 30528-1151
(706) 348-2004
(706) 348-2014
Mailing address
10 S. BROOK ST., STE. 2, CLEVELAND, GA 30528-0014
(706) 348-2004
(706) 348-2014
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
624036001
GA
Other
Enumeration date
10/20/2006
Last updated
07/14/2009
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