Healthcare Provider Details

I. General information

NPI: 1144302555
Provider Name (Legal Business Name): QUEST REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5427-B GEX RD
DIAMONDHEAD MS
39525-3208
US

IV. Provider business mailing address

5427-B GEX RD
DIAMONDHEAD MS
39525-3208
US

V. Phone/Fax

Practice location:
  • Phone: 228-255-0450
  • Fax: 228-255-5496
Mailing address:
  • Phone: 228-255-0450
  • Fax: 228-255-5496

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 Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELIQUE RYBAR
Title or Position: DIRECTOR OF BUSINESS OPERATIONS
Credential:
Phone: 228-255-0450