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General NPI Number Information
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NPI Number | 1649729310
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Entity Type | Organization
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Legal Business Name | MR. CHESTER RHINES
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 4204 STONEBRIAR TRL
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City | MANSFIELD
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State | TX
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Zip | 76063-5875
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Country | US
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Telephone | 817-592-3021
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Fax | 888-557-1669
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Provider Business Mailing Address
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Address Line | 4204 STONEBRAIR TRAIL
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City | MANSFIELD
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State | TX
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Zip | 76030
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Country | US
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Telephone | 817-592-3021
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Fax | 888-557-1669
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. CHESTER R RHINES
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Credential | PT
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Telephone | 817-592-3021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1171843
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License Number State | TX
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