Basic Information
| Provider Information | |||||||||
| NPI: | 1932104619 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | REHAB AT WORK PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 65 DUTCH LN | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 397025523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622414545 | ||||||||
| FaxNumber: | 6622414025 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 DUTCH LN | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 397025523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622414545 | ||||||||
| FaxNumber: | 6622414025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2005 | ||||||||
| LastUpdateDate: | 05/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | WRIGHT | ||||||||
| AuthorizedOfficialFirstName: | TRACI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6622414545 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | OTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.