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General NPI Number Information
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NPI Number | 1114965670
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Entity Type | Organization
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Legal Business Name | MEDICAL REHABILITATION ASSOCIATES
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 77 BATES ST SUITE 102
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City | LEWISTON
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State | ME
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Zip | 04240-7637
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Country | US
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Telephone | 207-783-6108
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Fax | 207-514-1425
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Provider Business Mailing Address
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Address Line | 77 BATES ST SUITE 102
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City | LEWISTON
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State | ME
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Zip | 04240-7637
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Country | US
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Telephone | 207-783-6108
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Fax | 207-783-2439
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Authorized Official
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Title or Position | ACCOUNTS RECEIVABLE MANAGER
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Name | MISS JODY LEIGH SIMPSON
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Credential |
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Telephone | 207-783-6108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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