Healthcare Provider Details

I. General information

NPI: 1700101151
Provider Name (Legal Business Name): PRO STEP REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W NASHVILLE ST
PEMBROKE KY
42266-9763
US

IV. Provider business mailing address

75 BUCKNER ST
MADISONVILLE KY
42431-2749
US

V. Phone/Fax

Practice location:
  • Phone: 270-475-4227
  • Fax:
Mailing address:
  • Phone: 270-933-8281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHERINE J BRATCHER
Title or Position: FRC
Credential: COTA
Phone: 270-475-4227