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General NPI Number Information
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NPI Number | 1356354930
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Entity Type | Organization
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Legal Business Name | RELIANT REHAB SERVICE AND SUPPLY
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 2601 MORNINGSIDE DR
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3644
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Country | US
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Telephone | 715-552-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 MORNINGSIDE DR
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3644
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Country | US
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Telephone | 715-552-3711
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | RYAN D BURR
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Credential | CPA
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Telephone | 715-552-3711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 004000004276301
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License Number State | WI
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