MEDICARE: NATIONAL REHABILITATION CARE

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	05004444A	IN

General Provider Information

NPI Number	:	1083714505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL REHABILITATION CARE

Provider Business Mailing Address
First Line	:	5029 BACKLICK RD # A
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-6044
Country	:	US
Telephone Number	:	260-492-6197
Fax Number	:

Provider Business Practice Location Address
First Line	:	6642 SAINT JOE RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-1933
Country	:	US
Telephone Number	:	260-492-6197
Fax Number	:

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	DR. MOHAMMED MOTAWEA
Credential	:
Telephone Number	:	260-492-6197

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	08/22/2020

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Directions to “NATIONAL REHABILITATION CARE ” Practice Location

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