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General NPI Number Information
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NPI Number | 1144391327
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Entity Type | Organization
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Legal Business Name | REBKEB, INC.
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1801 S 74TH ST
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City | FORT SMITH
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State | AR
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Zip | 72903-2814
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Country | US
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Telephone | 479-478-5568
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Fax | 479-478-5567
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Provider Business Mailing Address
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Address Line | 2124 S 70TH ST
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City | FORT SMITH
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State | AR
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Zip | 72903-4038
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Country | US
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Telephone | 479-478-0106
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN ELIZABETH BRUCE
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Credential | OTR
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Telephone | 479-478-0106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR548
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License Number State | AR
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