MEDICARE: CENTERPOINT PHYSICAL MEDICINE AND REHABILITATION, PLLC

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	363LF0000X	Family Nurse Practitioner	AP4600	AZ

General Provider Information

NPI Number	:	1902150949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERPOINT PHYSICAL MEDICINE AND REHABILITATION, PLLC

Provider Business Mailing Address
First Line	:	9420 W BELL RD
Second Line	:	SUITE 105
City	:	SUN CITY
State	:	AZ
Zip	:	85351-1362
Country	:	US
Telephone Number	:	623-428-9469
Fax Number	:

Provider Business Practice Location Address
First Line	:	9420 W BELL RD
Second Line	:	SUITE 105
City	:	SUN CITY
State	:	AZ
Zip	:	85351-1362
Country	:	US
Telephone Number	:	623-428-9469
Fax Number	:

Authorized Official
Title or Position	:	OFFICE/BILLING MANAGER
Name	:	TERRI L. REBLIN
Credential	:
Telephone Number	:	602-751-4092

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	12/08/2012

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