=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437392529
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHAB MANAGEMENT RESOURCES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2009
-----------------------------------------------------
Last Update Date | 04/20/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 46 SGT PRENTISS DR SUITE 104
-----------------------------------------------------
City | NATCHEZ
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39120-4792
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-442-9654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 549 HIGHWAY 61 S
-----------------------------------------------------
City | NATCHEZ
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39120-9344
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-442-9654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MARCIA HUBBARD PASSMAN
-----------------------------------------------------
Credential | RPT
-----------------------------------------------------
Telephone | 601-442-9654
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------