MEDICARE: ABILENE PHYSICAL THERAPY AND SPORTS REHAB CLINIC, 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	225100000X	Physical Therapist	1-2353-9	TX

General Provider Information

NPI Number	:	1326234071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILENE PHYSICAL THERAPY AND SPORTS REHAB CLINIC, INC.

Provider Business Mailing Address
First Line	:	4127 S DANVILLE DR
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79605-7230
Country	:	US
Telephone Number	:	325-695-6011
Fax Number	:	325-695-4947

Provider Business Practice Location Address
First Line	:	4127 S DANVILLE DR
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79605-7230
Country	:	US
Telephone Number	:	325-695-6011
Fax Number	:	325-695-4947

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	WILLIAM (BILL) R. KEEBLE III
Credential	:	P.T.
Telephone Number	:	325-695-6011

Provider Enumeration Date	:	09/17/2007
Last Update Date	:	04/18/2008

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