Basic Information
| Provider Information | |||||||||
| NPI: | 1588080014 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RPM REHAB, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 FRANKLIN RD | ||||||||
| Address2: | STE 135A-102 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370273280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6157502015 | ||||||||
| FaxNumber: | 6153013918 | ||||||||
| Practice Location | |||||||||
| Address1: | 1815 E MAIN ST | ||||||||
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| City: | BARSTOW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923113234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602562800 | ||||||||
| FaxNumber: | 7602562809 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2014 | ||||||||
| LastUpdateDate: | 03/07/2014 | ||||||||
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| AuthorizedOfficialLastName: | HAWES | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6157502015 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CEO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP20220 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.