Healthcare Provider Details

I. General information

NPI: 1790887396
Provider Name (Legal Business Name): REHAB RESOURCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WOODLAND DR
RADCLIFF KY
40160
US

IV. Provider business mailing address

111 N WOODLAND DR
RADCLIFF KY
40160-2678
US

V. Phone/Fax

Practice location:
  • Phone: 270-351-3511
  • Fax: 270-351-3514
Mailing address:
  • Phone: 270-351-3511
  • Fax: 270-351-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. SHIGUFTA QURESHI
Title or Position: PRESIDENT,OWNER
Credential:
Phone: 270-351-3511