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NPI Code Detail

MEDICARE: WESTERN RESERVE REHAB GROUP LLC

MEDICARE: WESTERN RESERVE REHAB GROUP LLC
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
1225400000XRehabilitation PractitionerMD27171OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346429644
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN RESERVE REHAB GROUP LLC
Provider Business Mailing Address
First Line : 4628 SW 49TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97221-3019
Country : US
Telephone Number : 216-702-6944
Fax Number : 503-477-7338
Provider Business Practice Location Address
First Line : 2561 CENTER ST NE
Second Line :
City : SALEM
State : OR
Zip : 97301-4600
Country : US
Telephone Number : 503-561-5976
Fax Number : 503-561-4912
Authorized Official
Title or Position : MANAGING MEMBER
Name : MARIA A ARMSTRONG MURPHY
Credential : MD
Telephone Number : 216-702-6944
Provider Enumeration Date : 11/02/2007
Last Update Date : 03/05/2010

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Directions to “WESTERN RESERVE REHAB GROUP LLC ” Practice Location

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