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General NPI Number Information
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NPI Number | 1346830247
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HOME REHAB, PLLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 14815 W BELL RD STE 110
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City | SURPRISE
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State | AZ
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Zip | 85374-7603
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Country | US
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Telephone | 623-777-1870
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Fax | 623-777-1403
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Provider Business Mailing Address
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Address Line | 14815 W BELL RD STE 110
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City | SURPRISE
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State | AZ
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Zip | 85374-7603
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Country | US
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Telephone | 623-777-1870
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Fax | 623-777-1403
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | RAYMOND POPP
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Credential | MPT
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Telephone | 623-777-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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