Organization Name: | OCCUPATIONAL HEALTH CENTERS OF GEORGIA PC |
NPI Number: | 1407865108 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM TOM FOGARTY (PRESIDENT) |
Mailing Address: | 3580 Atlanta Avenue Hapeville |
State: | GA US |
Postal Code: | 30354 |
Phone Number: | 4047683351 |
Fax Number: | 4047680842 |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 07/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |