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General NPI Number Information
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NPI Number | 1871788489
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Entity Type | Organization
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Legal Business Name | TOTAL REHABILITATION, P.C.
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 3375 N LINDEN RD APT 151
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City | FLINT
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State | MI
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Zip | 48504-5719
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Country | US
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Telephone | 810-230-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 3375 N LINDEN RD APT 151
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City | FLINT
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State | MI
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Zip | 48504-5719
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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 | TERRY L GODDARD
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Credential | O.T.
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Telephone | 810-230-1030
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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