Organization Name: | ENCORE REHABILITATION INC |
NPI Number: | 1205962537 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL G HENDERSON (PRESIDENT) |
Mailing Address: | 2210 Mill Street Ext # B Lucedale |
State: | MS US |
Postal Code: | 394526064 |
Phone Number: | 6019479005 |
Fax Number: | 6019479007 |
NPI Enumeration Date: | 02/23/2007 |
NPI Last Update Date: | 05/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |