Healthcare Provider Details

I. General information

NPI: 1598809253
Provider Name (Legal Business Name): VECTOR REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 MYRTLE AVE
EUREKA CA
95501-3323
US

IV. Provider business mailing address

2121 MYRTLE AVE
EUREKA CA
95501-3323
US

V. Phone/Fax

Practice location:
  • Phone: 707-442-6463
  • Fax: 707-442-5427
Mailing address:
  • Phone: 707-442-6463
  • Fax: 707-442-5427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHELE LEE SHAW
Title or Position: OFFICE MANAGER
Credential:
Phone: 707-442-6463