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General NPI Number Information
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NPI Number | 1457590127
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Entity Type | Organization
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Legal Business Name | REHAB MASTERS, INC.
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 12191 CLIPPER DR
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City | LAKE RIDGE
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State | VA
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Zip | 22192-2237
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Country | US
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Telephone | 703-496-3486
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Fax |
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Provider Business Mailing Address
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Address Line | 8711 E PINNACLE PEAK RD # 347
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3517
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Country | US
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Telephone | 480-473-3790
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Fax | 480-473-3791
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Authorized Official
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Title or Position | PRESIDENT
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Name | BLAKE GILLMAN
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Credential |
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Telephone | 480-473-3790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 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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