Basic Information
| Provider Information | |||||||||
| NPI: | 1629403845 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SELECT REHAB. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3503 DAUPHINE ST | ||||||||
| Address2: | |||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338722890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8633854980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3429 S HIGHLANDS AVE | ||||||||
| Address2: | |||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338705408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8634716336 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2013 | ||||||||
| LastUpdateDate: | 09/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | ASHLEY | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | SPEECH PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8633854980 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | SA1831 | FL | Y | Hospitals | General Acute Care Hospital |
No ID Information.