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Organization

CLASSIC CITY REHAB LLC

Active
Other names
Classic City Rehab LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NIDHI PATEL PT, DPT, CERT-DN (CO-FOUNDER)
(706) 248-8706
Entity
Organization

Contact information

Practice address
184 TOWNS WALK DR, ATHENS, GA 30606-7986
(706) 424-5921
Mailing address
184 TOWNS WALK DR, ATHENS, GA 30606-7986

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2251N0400X
Neurology Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003331588
NON-MEDICARE
GA
01
1861973752
NON-MEDICARE
FL
Enumeration date
07/10/2020
Last updated
08/23/2020
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