Organization
CONCENTRA HEALTH SEVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM FOGARTY MD (EVP, CMO)
(800) 232-3550
Entity
Organization
Contact information
Practice address
109 MINIS AVE, SUITE C -10, GARDEN CITY, GA 31408-2128
(912) 966-5445
(912) 966-5955
Mailing address
5080 SPECTRUM DR, SUITE 1200 WEST TOWER, ADDISON, TX 75001-4648
(800) 232-3550
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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