MEDICARE: BRIGHTON REHABILITATION, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1073892055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTON REHABILITATION, LLC

Provider Business Mailing Address
First Line	:	206 N 2100 W
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84116-4740
Country	:	US
Telephone Number	:	801-532-4120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1434 PUNAHOU ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96822-4754
Country	:	US
Telephone Number	:	801-941-0941
Fax Number	:	808-949-4965

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLES RANDY KIRTON
Credential	:
Telephone Number	:	801-532-4120

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	11/16/2015

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Directions to “BRIGHTON REHABILITATION, LLC ” Practice Location

Language	Start Address	Practice Location

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