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General NPI Number Information
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NPI Number | 1194060509
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Entity Type | Organization
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Legal Business Name | WCK REHAB CENTER PLLC
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 2314 W OAKLAND PARK BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1422
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Country | US
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Telephone | 754-200-6844
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Fax | 754-200-6845
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Provider Business Mailing Address
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Address Line | 2314 W OAKLAND PARK BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1422
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Country | US
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Telephone | 754-200-6844
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Fax | 754-200-6845
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Authorized Official
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Title or Position | PRESIDENT
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Name | HENRI CLAUDE DOUZE
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Credential | D.C
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Telephone | 754-200-6844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | CH4902
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License Number State | FL
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