Organization
SUNDANCE REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEREE RUDDER PTA (THERAPY PROGRAM MANAGER)
(770) 683-6854
Entity
Organization
Contact information
Practice address
110 EDGEWORTH RD, NEWNAN, GA 30263-6916
(770) 683-6854
(770) 252-0886
Mailing address
110 EDGEWORTH RD, NEWNAN, GA 30263-6916
(770) 683-6854
(770) 252-0886
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
SLP007514
GA
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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