Healthcare Provider Details
I. General information
NPI: 1023845278
Provider Name (Legal Business Name): FOX REHAB PT AND OT KS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12345 W 95TH ST FL 2
LENEXA KS
66215-3853
US
IV. Provider business mailing address
7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US
V. Phone/Fax
- Phone: 877-407-3422
- Fax: 877-407-4329
- Phone: 877-407-3422
- Fax: 877-407-4329
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:
NEIL
WEISSHAAR
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 877-407-3422