Healthcare Provider Details

I. General information

NPI: 1710327457
Provider Name (Legal Business Name): REHABVISIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S 1ST ST
IOLA KS
66749-3505
US

IV. Provider business mailing address

521 N TENNESSEE ST
IOLA KS
66749-2629
US

V. Phone/Fax

Practice location:
  • Phone: 620-365-1052
  • Fax:
Mailing address:
  • Phone: 620-380-1561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number508
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number508
License Number StateKS

VIII. Authorized Official

Name: MS. SARAH L. BANNISTER
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MACCCSLP
Phone: 620-380-1561