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General NPI Number Information
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NPI Number | 1407981475
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Entity Type | Organization
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Legal Business Name | ENCORE REHABILIATION INC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 15476B DEDEAUX RD
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City | GULFPORT
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State | MS
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Zip | 39503-2637
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Country | US
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Telephone | 228-539-3232
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Fax | 228-539-3230
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Provider Business Mailing Address
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Address Line | PO BOX 8419
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City | BILOXI
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State | MS
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Zip | 39535-8087
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Country | US
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Telephone | 228-388-5714
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Fax | 228-388-0017
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL G HENDERSON
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Credential | PT
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Telephone | 256-350-1764
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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 |
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