Organization Name: | INTEGRATED REHABILITATION GROUP, PC |
NPI Number: | 1154369833 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL SHANNON O'KELLEY (PRESIDENT/OWNER) |
Mailing Address: | 4220 132nd St Se Suite 101 Mill Creek |
State: | WA US |
Postal Code: | 980128999 |
Phone Number: | 4253168046 |
Fax Number: | 4253389637 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |