Healthcare Provider Details
I. General information
NPI: 1669599031
Provider Name (Legal Business Name): REHAB & INDUSTRIAL SERVICES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2007
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
393 E 2ND N
REXBURG ID
83440-1605
US
IV. Provider business mailing address
325 HANSON ST
WINNEMUCCA NV
89445-3607
US
V. Phone/Fax
- Phone: 208-359-9570
- Fax: 208-359-9580
- Phone: 775-625-2222
- Fax: 775-625-1131
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
J
SNOW
Title or Position: PARTNER
Credential: DPT
Phone: 775-625-2222