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General NPI Number Information
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NPI Number | 1306915129
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Entity Type | Organization
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Legal Business Name | MULVANEY REHAB SERVICES LTD
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1007 S 42ND ST
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City | MOUNT VERNON
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State | IL
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Zip | 62864-6217
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Country | US
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Telephone | 618-244-1163
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Fax | 618-244-1522
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Provider Business Mailing Address
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Address Line | 4227 LINCOLNSHIRE DRIVE
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City | MOUNT VERNON
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State | IL
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Zip | 62864-2157
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Country | US
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Telephone | 618-242-2317
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Fax | 618-242-9710
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES M MULVANEY
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Credential | PT
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Telephone | 618-244-1163
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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 |
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License Number State | IL
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