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General NPI Number Information
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NPI Number | 1174532998
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Entity Type | Organization
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Legal Business Name | SPECIALIZED REHABILITATION, INC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9200 W CROSS DR STE 400
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City | LITTLETON
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State | CO
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Zip | 80123-0759
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Country | US
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Telephone | 303-904-8133
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Fax | 303-904-8109
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Provider Business Mailing Address
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Address Line | 9200 W CROSS DR STE 400
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City | LITTLETON
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State | CO
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Zip | 80123-0759
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Country | US
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Telephone | 303-904-8133
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Fax | 303-904-8109
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Authorized Official
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Title or Position | OWNER
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Name | MS. RENEE MARIE TEBON
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Credential | OTR, CHT, CLT-LANA
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Telephone | 303-904-8133
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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 | 003122
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License Number State |
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