MEDICARE: HEALTHPRO HERITAGE REHAB & FITNESS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational Therapist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1083123624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHPRO HERITAGE REHAB & FITNESS, LLC

Provider Business Mailing Address
First Line	:	536 OLD HOWELL RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-1969
Country	:	US
Telephone Number	:	864-244-3626
Fax Number	:

Provider Business Practice Location Address
First Line	:	12401 TRAIL OAKS DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-1701
Country	:	US
Telephone Number	:	405-638-3423
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, LICENSING/CERTIFICATION
Name	:	JULIE MCGLASSON
Credential	:
Telephone Number	:	615-406-3997

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	10/28/2025

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