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General NPI Number Information
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NPI Number | 1548234339
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Entity Type | Organization
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Legal Business Name | DEFIANCE REHABILITATION SERVICES
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 851 S CLINTON ST
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City | DEFIANCE
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State | OH
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Zip | 43512-2770
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Country | US
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Telephone | 419-782-8808
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Fax | 419-782-8148
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Provider Business Mailing Address
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Address Line | 851 S CLINTON ST
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City | DEFIANCE
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State | OH
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Zip | 43512-2770
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Country | US
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Telephone | 419-782-8808
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Fax | 419-782-8148
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Authorized Official
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Title or Position | OWNER
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Name | JIM KISSEL
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Credential | P.T. ATC
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Telephone | 419-782-8808
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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 | PT7200
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License Number State | OH
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