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General NPI Number Information
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NPI Number | 1124026844
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Entity Type | Organization
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Legal Business Name | COMMUNITY REHAB & WELLNESS INC
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 3021 LAKELAND HIGHLANDS RD
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City | LAKELAND
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State | FL
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Zip | 33803-4339
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Country | US
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Telephone | 863-688-5232
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Fax | 863-688-4153
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Provider Business Mailing Address
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Address Line | 3021 LAKELAND HIGHLANDS RD
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City | LAKELAND
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State | FL
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Zip | 33803-4339
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Country | US
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Telephone | 863-299-2749
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Fax | 863-299-2831
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. JULIE A SIMMONS
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Credential |
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Telephone | 863-299-2749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT796
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License Number State | FL
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