Healthcare Provider Details

I. General information

NPI: 1972543478
Provider Name (Legal Business Name): REHAB CHOICE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 W FOREST HOME AVE SUITE 50
GREENFIELD WI
53228-3417
US

IV. Provider business mailing address

2127 INNERBELT BUSINESS CENTER DR SUITE 107
SAINT LOUIS MO
63114-5700
US

V. Phone/Fax

Practice location:
  • Phone: 414-525-9999
  • Fax: 414-525-9971
Mailing address:
  • Phone: 314-506-8800
  • Fax: 314-506-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHERINE A DULLE
Title or Position: PRESIDENT
Credential:
Phone: 314-506-8800