Spectrum Rehabilitation Services, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

007723 Issued in GA

Legal business name

SPECTRUM REHABILITATION SERVICES, INC

Practice address

630 City Park Dr
McDonough, GA 30252-1018

Phone

(678) 923-2633

Fax

(678) 432-7498

NPI assigned

Aug 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Adam Medrzycki, PT

Title

Owner

Phone

(678) 923-2633

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992818462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2918",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302531778",
            "telephone_number": "678-923-2633",
            "fax_number": "678-432-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 CITY PARK DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521018",
            "telephone_number": "678-923-2633",
            "fax_number": "678-432-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM REHABILITATION SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEDRZYCKI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "16789232633",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "007723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in McDonough, GA
• Providers in McDonough, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.