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Organization
REHAB FRONTIER, LLC
Active
Organization
REHAB FRONTIER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOWELL S LIWANAG RPT, WCC, CWS (CHIEF MANAGER)
(863) 605-3681
Entity
Organization
Contact information
Practice address
2027 STATE ROAD 60 E, LAKE WALES, FL 33898-5113
(863) 678-1557
(863) 582-9279
Mailing address
PO BOX 1168, LAKE WALES, FL 33859-1168
(863) 678-1557
(863) 582-9279
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y922K
BCBSFL PROVIDER NUMBER
FL
Enumeration date
07/15/2006
Last updated
04/17/2008
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