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General NPI Number Information
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NPI Number | 1609833185
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Entity Type | Organization
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Legal Business Name | NATURE COAST REHABILITATION INC
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 1315 NW 21ST AVE
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City | CHIEFLAND
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State | FL
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Zip | 32626-1959
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Country | US
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Telephone | 352-493-2999
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Fax | 352-493-0026
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Provider Business Mailing Address
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Address Line | PO BOX 518
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City | WILLISTON
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State | FL
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Zip | 32696-0518
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Country | US
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Telephone | 352-493-2999
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Fax | 352-493-0026
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MS. ELIZABETH JOHNSON HICKS
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Credential | PT
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Telephone | 352-528-0022
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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 |
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License Number State |
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