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General NPI Number Information
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NPI Number | 1255377263
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Entity Type | Organization
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Legal Business Name | ANN L. RAEBEL, PT
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1420 S 8TH ST
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City | ROGERS
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State | AR
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Zip | 72756-5334
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Country | US
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Telephone | 479-631-7262
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Fax | 479-631-6366
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Provider Business Mailing Address
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Address Line | PO BOX 2234
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City | ROGERS
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State | AR
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Zip | 72757-2234
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Country | US
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Telephone | 479-631-7262
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Fax | 479-631-6366
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Authorized Official
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Title or Position | PA
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Name | ANN L RAEBEL
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Credential | PT
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Telephone | 479-631-7262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 1923
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License Number State | AR
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