OrganizationStarting Block Sports Medicine & RehabilitationChiropractorChiropractic ProvidersPractice Address105 Smoke Hill Ln, Suite 120, Woodstock, GA 30188-7364(678) 436-5866PECOS EnrollmentBased on the most recent information from CMS, provider Starting Block Sports Medicine & Rehabilitation does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1083936074Provider TypeOrganizationFull NameStarting Block Sports Medicine & RehabilitationSubpartNoEnumeration Date2/18/2010Last Updated2/18/2010Contact InformationPractice LocationPractice Address105 Smoke Hill Ln, Suite 120, Woodstock, GA 30188-7364Phone(678) 436-5866Fax(678) 262-3677Mailing LocationMailing Address105 Smoke Hill Ln, Suite 120, Woodstock, GA 30188-7364Phone(678) 436-5866Fax(678) 262-3677Authorized OfficialNamePaul, Jeffery Stuart (President)Phone(678) 436-5866Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseCHIRO008613GeorgiaCode2251S0007XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT005129GeorgiaCode2255A2300XDescriptionSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseAT001213Georgia