| Rhonda Lane Gray Therapy Services,inc. | |
|
601 N Belair Sq #19 Evans GA 30809-4321 | |
| (706) 833-7376 | |
| Not Available |
| Full Name | Rhonda Lane Gray Therapy Services,inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 601 N Belair Sq, Evans, Georgia |
| Authorized Official Name and Position | Rhonda Lane Gray (SPEECH-LANGUAGE PATHOLOGIST) |
| Authorized Official Contact | 7068337376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rhonda Lane Gray Therapy Services,inc. 1036 Barrett Dr Evans GA 30809-4029 Ph: (706) 833-7376 | Rhonda Lane Gray Therapy Services,inc. 601 N Belair Sq #19 Evans GA 30809-4321 Ph: (706) 833-7376 |
| NPI Number | 1366829137 |
|---|---|
| Provider Enumeration Date | 04/30/2015 |
| Last Update Date | 04/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366829137 | NPI | - | NPPES |
| 11885042 | Other | CAQH | |
| 000897993 | Medicaid | GA | |
| 01900609 | Other | GA | AMERIGROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | SLP004870 (Georgia) | Primary |
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