Healthcare Provider Details

I. General information

NPI: 1548417165
Provider Name (Legal Business Name): INDUSTRIAL REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 US HWY 90 WEST
MOBILE AL
36619
US

IV. Provider business mailing address

PO BOX 1108
MOBILE AL
36601-1108
US

V. Phone/Fax

Practice location:
  • Phone: 251-431-5800
  • Fax: 251-431-5810
Mailing address:
  • Phone: 251-431-5800
  • Fax: 251-431-5810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: BART BENSON
Title or Position: MANAGER
Credential:
Phone: 251-431-5802