Healthcare Provider Details

I. General information

NPI: 1043568942
Provider Name (Legal Business Name): FOX REHAB INDIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2012
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

IV. Provider business mailing address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 877-407-3422
  • Fax: 877-407-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. TIMOTHY FOX
Title or Position: PRESIDENT
Credential: PT, DPT, GCS
Phone: 877-407-3422