Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cedar Grove Rehab LLC

Organization Chiropractor · NPI 1255776613

Cedar Grove Rehab LLC is a Chiropractor in Ellenwood, Georgia. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3395 Bouldercrest Rd
Ellenwood, GA 30294-1639
Phone: (404) 241-3280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Chiropractor Taxonomy 111N00000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1255776613
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Otis Bonner — Attorney · (770) 940-4975
NPI enumeratedApril 30, 2013
Last updated in NPPESApril 30, 2013
Mailing address3395 Bouldercrest Rd, Ellenwood, GA 30294-1639

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