MEDICARE: REHAB & THERAPY CENTER INC

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
1	111N00000X	Chiropractor	CH8404	FL

General Provider Information

NPI Number	:	1528333119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB & THERAPY CENTER INC

Provider Business Mailing Address
First Line	:	3651 EVANS AVE
Second Line	:	SUITE 105
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8300
Country	:	US
Telephone Number	:	239-931-5633
Fax Number	:

Provider Business Practice Location Address
First Line	:	3651 EVANS AVE
Second Line	:	SUITE 105
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8300
Country	:	US
Telephone Number	:	239-931-5633
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HARRIETTA CECCARELLI
Credential	:	DC
Telephone Number	:	239-931-5633

Provider Enumeration Date	:	03/14/2012
Last Update Date	:	03/14/2012

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