MEDICARE: COMMUNITY HEALTH & REHAB CENTRE

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	1287159	TX

General Provider Information

NPI Number	:	1750815239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH & REHAB CENTRE

Provider Business Mailing Address
First Line	:	2013 WELLS BRANCH PKWY
Second Line	:	SUITE 104
City	:	AUSTIN
State	:	TX
Zip	:	78728-6900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 WELLS BRANCH PKWY
Second Line	:	SUITE 104
City	:	AUSTIN
State	:	TX
Zip	:	78728-6900
Country	:	US
Telephone Number	:	512-835-6077
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. NICOLE MARTIN
Credential	:	PT, DPT
Telephone Number	:	415-999-8625

Provider Enumeration Date	:	04/12/2017
Last Update Date	:	04/12/2017

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Directions to “COMMUNITY HEALTH & REHAB CENTRE ” Practice Location

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