Healthcare Provider Details

I. General information

NPI: 1952877060
Provider Name (Legal Business Name): ENCORE REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 HIGHWAY 45 ALT S STE 1277
WEST POINT MS
39773-0414
US

IV. Provider business mailing address

251 JOHNSTON ST SE STE 200
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 662-494-5579
  • Fax:
Mailing address:
  • Phone: 125-635-0176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL HENDERSON
Title or Position: PRESIDENT
Credential:
Phone: 256-350-1764