Organization
GEORGIA GERIATRICS AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE DAVID BEAVERS III PT, DPT, GCS (OWNER)
(404) 438-7445
Entity
Organization
Contact information
Practice address
549 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-6347
(404) 438-7445
Mailing address
549 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-6347
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/06/2018
Last updated
11/07/2023
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