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General NPI Number Information
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NPI Number | 1396994133
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Entity Type | Organization
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Legal Business Name | SOUTHERN SPINAL REHAB, LLC
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 91 W HOOD DR
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City | PENSACOLA
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State | FL
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Zip | 32534-3019
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Country | US
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Telephone | 850-475-4227
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Fax | 850-475-8200
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Provider Business Mailing Address
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Address Line | 91 W HOOD DR
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City | PENSACOLA
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State | FL
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Zip | 32534-3019
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Country | US
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Telephone | 850-475-4227
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Fax | 850-475-8200
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | DR. STEPHEN B HAAS
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Credential | D.C.
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Telephone | 850-475-4227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 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 #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6329
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License Number State | FL
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