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General NPI Number Information
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NPI Number | 1861630378
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Entity Type | Organization
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Legal Business Name | REHAB PROVIDERS INC
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 1527 SILVER ST
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City | JACKSONVILLE
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State | FL
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Zip | 32206-4443
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Country | US
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Telephone | 904-891-0782
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Fax | 904-357-0061
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Provider Business Mailing Address
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Address Line | 1527 SILVER ST
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City | JACKSONVILLE
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State | FL
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Zip | 32206-4443
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Country | US
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Telephone | 904-891-0782
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Fax | 904-357-0061
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHRISTOPHER WAYNE FEARON
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Credential | PT
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Telephone | 904-891-0782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT21735
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License Number State | FL
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