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General NPI Number Information
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NPI Number | 1629118005
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Entity Type | Organization
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Legal Business Name | BELLEVILLE REHABILITATION SERVICES,LTD
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 333 S ILLINOIS ST SUITE D
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City | BELLEVILLE
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State | IL
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Zip | 62220-2153
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Country | US
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Telephone | 618-236-1081
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Fax | 618-236-1265
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Provider Business Mailing Address
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Address Line | 333 S ILLINOIS ST SUITE D
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City | BELLEVILLE
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State | IL
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Zip | 62220-2153
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Country | US
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Telephone | 618-236-1081
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Fax | 618-236-1265
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT NORTON KLOPPER
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Credential | PHYSICAL THERAPIST
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Telephone | 618-236-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | IL
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