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General NPI Number Information
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NPI Number | 1710318050
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Entity Type | Organization
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Legal Business Name | THREE BROTHERS REHAB, INC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 1074 NW 13TH ST UNIT 171C
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City | BOCA RATON
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State | FL
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Zip | 33486-2284
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Country | US
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Telephone | 954-821-0931
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Fax |
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Provider Business Mailing Address
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Address Line | 1074 NW 13TH ST UNIT 171C
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City | BOCA RATON
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State | FL
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Zip | 33486-2284
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Country | US
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Telephone | 954-821-0931
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JIA YU
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Credential | OTR
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Telephone | 954-821-0931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR14713
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License Number State | FL
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