Healthcare Provider Details

I. General information

NPI: 1558473330
Provider Name (Legal Business Name): MATHIS REHAB CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVENUE G200
MANHATTAN KS
66502-2770
US

IV. Provider business mailing address

2021 VANESTA PLACE SUITE D
MANHATTAN KS
66503-8707
US

V. Phone/Fax

Practice location:
  • Phone: 785-320-6616
  • Fax: 785-320-6667
Mailing address:
  • Phone: 785-320-6616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-00445
License Number StateKS

VIII. Authorized Official

Name: JEFFREY C MATHIS
Title or Position: OWNER
Credential: OTR/L,CHT
Phone: 785-320-6616