MEDICARE: SELECT REHABILITATION

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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1376110114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT REHABILITATION

Provider Business Mailing Address
First Line	:	209 RUGBY LN
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-5982
Country	:	US
Telephone Number	:	469-288-1808
Fax Number	:

Provider Business Practice Location Address
First Line	:	3690 MAPLESHADE LN
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-5715
Country	:	US
Telephone Number	:	903-868-0593
Fax Number	:

Authorized Official
Title or Position	:	COTA. PRN
Name	:	MRS. JENNIFER DIANE SMITH-REED
Credential	:	COTA
Telephone Number	:	469-288-1808

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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Directions to “SELECT REHABILITATION ” Practice Location

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