Healthcare Provider Details

I. General information

NPI: 1144666934
Provider Name (Legal Business Name): REHAB VISIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 CHOKECHERRY ST
WILLISTON ND
58801-2926
US

IV. Provider business mailing address

2710 CHOKECHERRY ST
WILLISTON ND
58801-2926
US

V. Phone/Fax

Practice location:
  • Phone: 970-812-6140
  • Fax:
Mailing address:
  • Phone: 970-812-6140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1022
License Number StateND

VIII. Authorized Official

Name: MRS. DEBRA E VASSEN
Title or Position: PTA
Credential:
Phone: 970-812-6140