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General NPI Number Information
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NPI Number | 1841783818
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Entity Type | Organization
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Legal Business Name | ALEXANDRIA REHABILITATION , LLC
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 104 N 3RD ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301
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Country | US
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Telephone | 318-449-1370
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Fax | 318-449-8495
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Provider Business Mailing Address
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Address Line | 1813 NORTHPOINTE LN
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City | RUSTON
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State | LA
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Zip | 71270-3879
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Country | US
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Telephone | 318-255-7591
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Fax | 318-255-7584
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Authorized Official
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Title or Position | OWNER
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Name | DR. HARRY J. LENABURG
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Credential | M.D.
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Telephone | 318-449-1370
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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 | LA
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