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General NPI Number Information
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NPI Number | 1093778805
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Entity Type | Organization
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Legal Business Name | MJF REHABILITATION PA
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 551 HILL COUNTRY DR
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City | KERRVILLE
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State | TX
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Zip | 78028-6085
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Country | US
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Telephone | 830-315-2106
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Fax | 830-315-2108
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Provider Business Mailing Address
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Address Line | PO BOX 290142
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City | KERRVILLE
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State | TX
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Zip | 78029-0142
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Country | US
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Telephone | 830-315-2106
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Fax | 830-315-2108
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Authorized Official
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Title or Position | MEMBER
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Name | DR. MIRELLE JEANNE FOSTER
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Credential | MD
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Telephone | 830-315-2106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | L3966
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License Number State | TX
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