MEDICARE: AFFINITY REHABILITATION ASSOCIATES 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1558617159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY REHABILITATION ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	23015 STEEPLE BLF
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-1603
Country	:	US
Telephone Number	:	210-875-9057
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 BLANCO RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-3244
Country	:	US
Telephone Number	:	210-875-9057
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	CAROLINA REYES
Credential	:	PT
Telephone Number	:	210-875-9057

Provider Enumeration Date	:	08/01/2012
Last Update Date	:	08/01/2012

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