Healthcare Provider Details

I. General information

NPI: 1437129566
Provider Name (Legal Business Name): REHAB RESOURCES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 MADISON ST
BEAVER DAM WI
53916-2629
US

IV. Provider business mailing address

1223 MADISON ST
BEAVER DAM WI
53916-2629
US

V. Phone/Fax

Practice location:
  • Phone: 920-885-4750
  • Fax: 920-885-3839
Mailing address:
  • Phone: 920-885-4750
  • Fax: 920-885-3839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JANICE MARIE STEVENS
Title or Position: PRESIDENT
Credential: OTR
Phone: 920-885-4750