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NPI Code Detail

MEDICARE: PREMERE REHAB LLC

MEDICARE: PREMERE REHAB 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1811278351
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMERE REHAB LLC
Provider Business Mailing Address
First Line : 25117 SW PARKWAY AVE
Second Line : SUITE D
City : WILSONVILLE
State : OR
Zip : 97070-9697
Country : US
Telephone Number : 888-757-3422
Fax Number :
Provider Business Practice Location Address
First Line : 1216 EAST 1300 SOUTH
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-1949
Country : US
Telephone Number : 801-478-8965
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MIKE BILLINGS
Credential :
Telephone Number : 888-757-3422
Provider Enumeration Date : 08/29/2011
Last Update Date : 01/02/2013

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Directions to “PREMERE REHAB LLC ” Practice Location

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