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General NPI Number Information
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NPI Number | 1306284385
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Entity Type | Organization
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Legal Business Name | ACCELERATED REHAB & PERFORMANCE, INC
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 340 W HIGHLAND DR
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City | LAKELAND
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State | FL
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Zip | 33813-1543
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Country | US
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Telephone | 239-404-7277
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Fax |
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Provider Business Mailing Address
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Address Line | 340 W HIGHLAND DR
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City | LAKELAND
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State | FL
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Zip | 33813-1543
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT, PHYSICAL THERAPIST
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Name | DR. JENNIFER M RIVERA
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Credential | PT, DPT, RKC
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Telephone | 239-404-7277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT27184
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License Number State | FL
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