Organization
ATLANTA SOUTH PHYSICAL THERAPY, INC
Active
Other names
Rehab South
Organization subpart
No
Provider details
NPI number
Authorized official
TROY BAGE (PRESIDENT)
(423) 238-7217
Entity
Organization
Contact information
Practice address
1275 HIGHWAY 54 W, SUITE 202, FAYETTEVILLE, GA 30214-4544
(770) 460-8609
(770) 460-8611
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD7784
RAILROAD MEDICARE GROUP PROVIDER #
GA
Enumeration date
03/05/2008
Last updated
04/15/2010
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