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Organization
TRI-VISTA REHAB, INC.
Active
Organization
TRI-VISTA REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BOUTIN (PRESIDENT/OWNER)
(662) 231-7304
Entity
Organization
Contact information
Practice address
285 W OXMOOR RD, BIRMINGHAM, AL 35209-6314
(205) 942-3355
Mailing address
PO BOX 3592, TUPELO, MS 38803-3592
(662) 840-0535
(662) 842-7915
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
09/10/2014
Last updated
10/20/2014
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