Healthcare Provider Details

I. General information

NPI: 1487821252
Provider Name (Legal Business Name): RX REHABILITATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 COUNTY ROAD CH
DODGEVILLE WI
53533-9108
US

IV. Provider business mailing address

4601 W BLUE MOUNDS RD
BARNEVELD WI
53507-9720
US

V. Phone/Fax

Practice location:
  • Phone: 608-935-3321
  • Fax:
Mailing address:
  • Phone: 608-513-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number3829024
License Number StateWI

VIII. Authorized Official

Name: MR. MARK J MEIVES
Title or Position: OWNER
Credential: PT
Phone: 608-513-1518