1Source Fitness & Sports Neuro Rehab
Organization Active NPI Home Health Agency · Snellville, GA
NPI 1184174161 · NPPES record last updated Oct 13, 2016
Key facts
- NPI
- 1184174161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 12002969 (GA)
- Legal business name
- 1SOURCE FITNESS & SPORTS NEURO REHAB
- Practice address
- 4728 Joseph Eli Dr
Snellville, GA 30039-7138 - Phone
- (678) 257-4037
- Fax
- (678) 257-4037
- NPI assigned
- Oct 13, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- 1SOURCE FITNESS & SPORTS NEURO REHAB
Authorized official
- Name
- Collin Adu, DPT.GCS. MBA
- Title
- Clinical Director
- Phone
- (678) 250-4035
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 1
Practitioners 1
-
Collin T Adu, DPT.GCS.FAAOMPT. MBA
National Provider Directory
- Tax ID family
- 1 Source Fitness Sports
- Part of
- 1 Source Fitness Sports
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 12002969 | GA | Yes |
Addresses
Primary practice location
4728 Joseph Eli Dr
Snellville, GA 30039-7138
Mailing address
4728 Joseph Eli Dr
Snellville, GA 30039-7138
Phone (678) 257-4037
Other names
- 1Source Health Services
Other providers in Snellville, GA
- 4 Plus 1 Enterprises, LLC
- 4Ever Wellcare Services
- 53 Acupuncture and Massage Inc
- A and E Medical Discounters
- A Baby Consultant, LLC
All providers in Snellville, GA · Home Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.