Organization Name: | INFINITY REHAB |
NPI Number: | 1043601602 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROWENA J WIER (COTA) |
Mailing Address: | 8750 Se 155th Ave 18 Happy Valley |
State: | OR US |
Postal Code: | 970865533 |
Phone Number: | 5032671610 |
Fax Number: | |
NPI Enumeration Date: | 02/17/2015 |
NPI Last Update Date: | 02/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | 408047 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |