Provider Demographics
NPI:1124115340
Name:ABILITYONE REHAB INC
Entity type:Organization
Organization Name:ABILITYONE REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:DK
Authorized Official - Last Name:ILORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-432-2044
Mailing Address - Street 1:1225 MCALLISTAR DR
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-2467
Mailing Address - Country:US
Mailing Address - Phone:678-432-2044
Mailing Address - Fax:
Practice Address - Street 1:1225 MCALLISTAR DR
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-2467
Practice Address - Country:US
Practice Address - Phone:678-432-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006197225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty