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NPI 1255638300

NPI 1255638300 : HEALTH & REHAB CLINIC : TALLAHASSEE, FL

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General NPI Number Information
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    NPI Number           |    1255638300
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    Entity Type          |    Organization 
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    Legal Business Name  |    HEALTH & REHAB CLINIC 
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Dates
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    Enumeration Date     |    02/24/2011
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    Last Update Date     |    02/24/2011
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Provider Practice Location Address
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    Address Line         |    108 W 5TH AVE 
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    City                 |    TALLAHASSEE
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    State                |    FL
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    Zip                  |    32303-6125
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    Country              |    US
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    Telephone            |    850-224-0033
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    Fax                  |    850-224-0033
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Provider Business Mailing Address
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    Address Line         |    108 W 5TH AVE 
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    City                 |    TALLAHASSEE
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    State                |    FL
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    Zip                  |    32303-6125
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    Country              |    US
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    Telephone            |    850-224-0033
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    Fax                  |    850-224-0033
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MARLAINE  RAYMOND 
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    Credential           |    
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    Telephone            |    850-224-0033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    111NR0400X
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    Taxonomy Name        |    Rehabilitation Chiropractor
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    License Number       |    
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    License Number State |    
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