MEDICARE: TEE'S FITNESS & REHABILITATION CENTER

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1447342621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEE'S FITNESS & REHABILITATION CENTER

Provider Business Mailing Address
First Line	:	1710 EVANS ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-3436
Country	:	US
Telephone Number	:	337-494-1235
Fax Number	:

Provider Business Practice Location Address
First Line	:	2808 BROAD ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70615-4961
Country	:	US
Telephone Number	:	337-494-1235
Fax Number	:

Authorized Official
Title or Position	:	OWNER & OPERATOR
Name	:	MISS TAMMY RENEE MAYO
Credential	:
Telephone Number	:	337-494-1235

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/22/2020

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