Provider Demographics
NPI:1104074913
Name:HEALTH REHABILITATION PROFESSIONALS
Entity type:Organization
Organization Name:HEALTH REHABILITATION PROFESSIONALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUEENSTON
Authorized Official - Middle Name:U
Authorized Official - Last Name:THORPE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:678-910-2106
Mailing Address - Street 1:3636 JUHAN RD
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4309
Mailing Address - Country:US
Mailing Address - Phone:678-910-2106
Mailing Address - Fax:770-465-5304
Practice Address - Street 1:923 COMMERCIAL ST NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4537
Practice Address - Country:US
Practice Address - Phone:770-760-8870
Practice Address - Fax:770-760-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy