Healthcare Provider Details

I. General information

NPI: 1831192970
Provider Name (Legal Business Name): GREENE REHAB SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 08/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S. TAMIAMI TRL SUITE 207
VENICE FL
34285-2424
US

IV. Provider business mailing address

333 S. TAMIAMI TRL SUITE 207
VENICE FL
34285-2424
US

V. Phone/Fax

Practice location:
  • Phone: 941-484-2471
  • Fax: 941-484-5487
Mailing address:
  • Phone: 941-484-2471
  • Fax: 941-484-5487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTINE ANN GREENE
Title or Position: ADMINISTRATOR
Credential: PHYSICAL THERAPIST
Phone: 941-484-2471