MEDICARE: ENCORE REHABILITATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1003819608	OTHER	AL	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073648036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCORE REHABILITATION INC

Provider Business Mailing Address
First Line	:	251 JOHNSTON ST SE STE 300
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-2515
Country	:	US
Telephone Number	:	256-340-9708
Fax Number	:	256-340-9624

Provider Business Practice Location Address
First Line	:	208 OFFICE PARK DR
Second Line	:
City	:	GULF SHORES
State	:	AL
Zip	:	36542-3432
Country	:	US
Telephone Number	:	251-948-2045
Fax Number	:	251-948-2048

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL G HENDERSON
Credential	:	PT
Telephone Number	:	256-350-1764

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	12/02/2020

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Directions to “ENCORE REHABILITATION INC ” Practice Location

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