MEDICARE: WESTON REHABILITATION KENTUCKY LLC

Medicare Provider Information

Scope of Practice

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

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

General Provider Information

NPI Number	:	1689975757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTON REHABILITATION KENTUCKY LLC

Provider Business Mailing Address
First Line	:	3131 ELLIOTT AVE
Second Line	:	SUITE 500
City	:	SEATTLE
State	:	WA
Zip	:	98121-1031
Country	:	US
Telephone Number	:	206-298-2909
Fax Number	:	206-301-4500

Provider Business Practice Location Address
First Line	:	400 FARRELL DRIVE
Second Line	:
City	:	FORT WRIGHT
State	:	KY
Zip	:	41011-3785
Country	:	US
Telephone Number	:	859-341-0777
Fax Number	:	859-341-1381

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GRANGER COBB
Credential	:
Telephone Number	:	206-298-2909

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	11/05/2010

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Directions to “WESTON REHABILITATION KENTUCKY LLC ” Practice Location

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