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NPI Code Detail

MEDICARE: REHABPROS LLC

MEDICARE: REHABPROS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1305R00000XPreferred Provider Organization

General Provider Information

NPI Number : 1073137592
Entity Type Code : Organization
Provider Name (Legal Business Name) : REHABPROS LLC
Provider Business Mailing Address
First Line : 6757 CASCADE RD SE # 136
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-6849
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6757 CASCADE RD SE # 136
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-6849
Country : US
Telephone Number : 616-383-5678
Fax Number :
Authorized Official
Title or Position : CEO
Name : STEVEN DAVIDSON
Credential :
Telephone Number : 616-383-5678
Provider Enumeration Date : 06/01/2020
Last Update Date : 06/01/2020

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Directions to “REHABPROS LLC ” Practice Location

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