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General NPI Number Information
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NPI Number | 1942308689
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Entity Type | Organization
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Legal Business Name | CANCER REHAB & EDEMA SPECIALIST
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 4715 AIRPORT BLVD STE 310
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City | MOBILE
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State | AL
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Zip | 36608-3181
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Country | US
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Telephone | 251-344-4212
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Fax | 251-344-4302
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Provider Business Mailing Address
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Address Line | 4715 AIRPORT BLVD STE 310
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City | MOBILE
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State | AL
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Zip | 36608-3181
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Country | US
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Telephone | 251-344-4212
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Fax | 251-344-4302
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA TAYLOR
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Credential | P.T.
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Telephone | 251-344-4212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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