Organization Name: | SURGICAL AND REHAB SERVICES INC |
NPI Number: | 1265657068 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RHONDA MAYNE (PRESIDENT) |
Mailing Address: | E4051 Steven Way Spring Green |
State: | WI US |
Postal Code: | 535889271 |
Phone Number: | 6085887756 |
Fax Number: | 8883296432 |
NPI Enumeration Date: | 04/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | OTC-96-0579 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |