=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538472691
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABILITATION HOSPITAL OF CAPE & ISLANDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2010
-----------------------------------------------------
Last Update Date | 07/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 280D ROUTE 130 SUITE 7
-----------------------------------------------------
City | FORESTDALE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02644-1140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-833-1060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 280D ROUTE 130 SUITE 7
-----------------------------------------------------
City | FORESTDALE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02644-1140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-833-1060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST ASSISTANT
-----------------------------------------------------
Name | MS. ANN-MARIE WALKER
-----------------------------------------------------
Credential | PTA
-----------------------------------------------------
Telephone | 508-833-1969
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 2486
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------