Healthcare Provider Details

I. General information

NPI: 1700075314
Provider Name (Legal Business Name): APPALACHIAN REHABILITATION TEAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 MEDICAL PLAZA LANE SUITE A
WHITESBURG KY
41858
US

IV. Provider business mailing address

149 MEDICAL PLAZA LANE SUITE A
WHITESBURG KY
41858
US

V. Phone/Fax

Practice location:
  • Phone: 606-632-1188
  • Fax: 606-632-0075
Mailing address:
  • Phone: 606-632-1188
  • Fax: 606-632-0075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SUSIE HOWARD
Title or Position: OFFICE MANAGER
Credential:
Phone: 606-632-1188