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General NPI Number Information
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NPI Number | 1568849958
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Entity Type | Organization
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Legal Business Name | HEALTHPRO REHABILITATION
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 3939 PENHURST AVE
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City | BALTIMORE
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State | MA
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Zip | 21215
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Country | US
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Telephone | 443-525-7577
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Fax |
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Provider Business Mailing Address
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Address Line | 3939 PENHURST AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5632
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REHABILITATION DIRECTOR
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Name | DR. XUAN ZHAO
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Credential | DPT
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Telephone | 443-525-7577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 25061
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License Number State | MD
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