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General NPI Number Information
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NPI Number | 1760812655
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Entity Type | Organization
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Legal Business Name | PHYSICAL REHAB LLC
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 3330 MASONIC DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3841
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Country | US
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Telephone | 318-448-6962
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Fax |
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Provider Business Mailing Address
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Address Line | 5255 RUE MARIA
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2271
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FARHEEN KHAN
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Credential | D.O
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Telephone | 504-251-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | DO.000285
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License Number State | LA
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