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Organization
INTEGRATED REHAB. PA
Active
Organization
INTEGRATED REHAB. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK NILES PT, MS, CSCS (OWNER)
(954) 816-1029
Entity
Organization
Contact information
Practice address
2180 SW 115TH TER, DAVIE, FL 33325-4854
(954) 816-1029
(954) 577-3444
Mailing address
2180 SW 115TH TER, DAVIE, FL 33325-4854
(954) 816-1029
(954) 577-3444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4421
FL
Other
Enumeration date
08/30/2006
Last updated
02/05/2008
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