Sovereign Rehabilitation of Georgia, LLC

NPI #1194267260 in Conyers, Georgia

Provider Information

NPI Number: 1194267260
Entity Type: Organization
Organization Name: Sovereign Rehabilitation of Georgia, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 7, 2016
Last Updated: Nov 7, 2016

Practice Location

Address: 1301 SIGMAN RD NE
Address 2: SUITE 220
City: Conyers
State: Georgia
ZIP Code: 30012-3812
Phone: (678) 210-0311

Authorized Official

Name: COLETTE JOHNSON
Title: VP OF OPERATIONS
Phone: (404) 680-6470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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