| South Georgia Therapy Services, P.c. | |
|
104 W Rustin St, Glennville, GA 30427-1805 | |
| (912) 654-2385 | |
| (912) 654-2394 |
| Full Name | South Georgia Therapy Services, P.c. |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 104 W Rustin St, Glennville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104080266 | NPI | - | NPPES |
| 161037534A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT003337 (Georgia) | Primary |
| Provider Name | Kenneth L Durrence |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982613568 PECOS PAC ID: 1355340084 Enrollment ID: I20061207000089 |
| Provider Name | Victoria K Griffith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205065042 PECOS PAC ID: 2264575240 Enrollment ID: I20100201000055 |
| Mailing Address | Practice Location Address |
|---|---|
| South Georgia Therapy Services, P.c. 104 W Rustin St, Glennville, GA 30427-1805 Ph: (912) 654-2385 | South Georgia Therapy Services, P.c. 104 W Rustin St, Glennville, GA 30427-1805 Ph: (912) 654-2385 |
Mrs. Victoria Kangeter Griffith, D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 104 W Rustin Street, Glennville, GA 30427 Phone: 912-654-2385 Fax: 912-654-2394 | |
Kenneth Lane Durrence, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 104 W. Rustin St., Glennville, GA 30427 Phone: 912-739-4739 |