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General NPI Number Information
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NPI Number | 1306650635
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Entity Type | Organization
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Legal Business Name | ENCORE REHABILITATION INC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1105 39TH AVE
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City | GULFPORT
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State | MS
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Zip | 39501-2654
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Country | US
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Telephone | 228-575-4654
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Fax | 225-575-4651
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Provider Business Mailing Address
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Address Line | 42465 HIGHWAY 195
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City | HALEYVILLE
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State | AL
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Zip | 35565-7052
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Country | US
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Telephone | 256-350-1764
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Fax |
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Authorized Official
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Title or Position | PROVIDER CREDENTIALING
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Name | KELSEY MCNUTT
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Credential |
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Telephone | 256-350-1764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical 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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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