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Organization
ALLEGIANT REHAB
Active
Organization
ALLEGIANT REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DER JUANA SHARMEN THOMPSON COTA (CERTIFIED OCCUPATIONAL THERAPY ASST)
(313) 559-5535
Entity
Organization
Contact information
Practice address
753 MAIN STREET STREET, STE C, ALAMO, TX 78516
(313) 559-5535
Mailing address
753 MAIN STREET STREET, STE C, ALAMO, TX 78516
(313) 559-5535
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
210898
TX
261QR0400X
Rehabilitation Clinic/Center
5202007235
MI
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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