Organization
SUNDANCE REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOLLY C GRAHAM M.ED. CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(912) 537-4813
Entity
Organization
Contact information
Practice address
1305 NORTHEAST MAIN STREET, VIDALIA, GA 30475
(912) 537-4813
(912) 537-6238
Mailing address
PO BOX 464, 1305 NORTHEAST MAIN STREET, VIDALIA, GA 30475
(912) 537-4813
(912) 537-6238
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
SLP006437
GA
314000000X
Skilled Nursing Facility
Primary
SLP006437
GA
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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