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General NPI Number Information
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NPI Number | 1235764473
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Entity Type | Organization
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Legal Business Name | TACTICAL REHABILITATION INC
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 15110 UNION AVE SW
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City | LAKEWOOD
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State | WA
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Zip | 98498-2093
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Country | US
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Telephone | 360-406-4891
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Fax | 910-210-0791
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Provider Business Mailing Address
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Address Line | PO BOX 1306
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City | JACKSONVILLE
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State | NC
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Zip | 28541-1306
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Country | US
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Telephone | 423-262-9720
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | KAREN C LYONS
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Credential |
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Telephone | 423-262-9720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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