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General NPI Number Information
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NPI Number | 1023262219
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Entity Type | Organization
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Legal Business Name | JETHWAN REHABILITATION GROUP INC
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 310 SE 29TH PL SUITE 200
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City | OCALA
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State | FL
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Zip | 34471-0486
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Country | US
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Telephone | 352-732-4006
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Fax | 352-732-5006
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Provider Business Mailing Address
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Address Line | 9401 SW HWY 200 BLDG 6000 STE 6002
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City | OCALA
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State | FL
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Zip | 34480
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Country | US
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Telephone | 352-237-0073
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Fax | 352-732-5006
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MEENU JETHWANI
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Credential | OTR/L CLT
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Telephone | 352-732-4006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | OT4799
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License Number State | FL
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