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General NPI Number Information
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NPI Number | 1750831905
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Entity Type | Organization
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Legal Business Name | DOUGLAS REHABILITATION LLC
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 92 BRICK RD
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City | MARLTON
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State | NJ
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Zip | 08053-2177
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Country | US
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Telephone | 856-809-0689
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Fax | 856-324-9006
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Provider Business Mailing Address
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Address Line | 7 GEORGE BINGHAM WAY
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City | MARLTON
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State | NJ
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Zip | 08053-7223
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Country | US
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Telephone | 856-809-0689
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | BARBARA DOUGLAS
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Credential | M.D.
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Telephone | 856-809-0689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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