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General NPI Number Information
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NPI Number | 1043634942
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Entity Type | Organization
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Legal Business Name | TRINITY REHABILITATION GROUP INC
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 6048 S SHERIDAN RD SUITE E
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City | TULSA
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State | OK
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Zip | 74145-9212
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Country | US
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Telephone | 918-935-2004
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Fax | 918-895-7887
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Provider Business Mailing Address
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Address Line | 6048 S SHERIDAN RD SUITE E
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City | TULSA
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State | OK
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Zip | 74145-9212
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Country | US
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Telephone | 918-935-2004
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Fax | 918-895-7887
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEROME E BLOCK
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Credential | MD
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Telephone | 918-935-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | OK
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