Healthcare Provider Details

I. General information

NPI: 1689974958
Provider Name (Legal Business Name): TX:TEAM REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 TRADITION CIR
MT PLEASANT SC
29466-7200
US

IV. Provider business mailing address

9101 WESLEYAN RD STE 100
INDIANAPOLIS IN
46268-3103
US

V. Phone/Fax

Practice location:
  • Phone: 843-654-7945
  • Fax:
Mailing address:
  • Phone: 317-884-3383
  • Fax:

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

VIII. Authorized Official

Name: MR. SCOTT BENEDICT
Title or Position: CEO
Credential:
Phone: 317-884-3383