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Organization
PREMERE REHAB LLC
Active
Organization
PREMERE REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA CANTRELL (VP COMMUNITY BASED SERVICES)
(360) 901-8111
Entity
Organization
Contact information
Practice address
25 SUNSHINE CT, DURANGO, CO 81301-6064
(970) 375-1580
Mailing address
25117 SW PARKWAY AVE, SUITE D, WILSONVILLE, OR 97070-9697
(888) 757-3422
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COA104421
PTAN
CO
Enumeration date
03/02/2011
Last updated
11/15/2021
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