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General NPI Number Information
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NPI Number | 1407137219
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Entity Type | Organization
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Legal Business Name | REHABILITATION THERAPY SERVICES INC.
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 107A W LINCOLN AVE
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City | OWENSVILLE
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State | MO
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Zip | 65066-1336
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Country | US
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Telephone | 573-437-7246
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Fax | 573-437-2868
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Provider Business Mailing Address
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Address Line | 107A W LINCOLN AVE
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City | OWENSVILLE
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State | MO
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Zip | 65066-1336
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Country | US
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Telephone | 573-437-7246
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Fax | 573-437-2868
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Authorized Official
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Title or Position | OWNER
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Name | DANICA NICKS
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Credential | P.T.
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Telephone | 573-437-7246
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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 | 12758469
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License Number State | MO
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