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Organization

REHAB ENGINEERING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY R FREDRICK C.P.O. (OWNER)
(850) 656-3599
Entity
Organization

Contact information

Practice address
2225 BEMISS ROAD, SUITE F, VALDOSTA, GA 31602
(229) 241-2005
(229) 241-9778
Mailing address
1719 MAHAN DRIVE, TALLAHASSEE, FL 32308
(850) 656-3599
(850) 656-6483

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
014
GA
335E00000X
Prosthetic/Orthotic Supplier
POR 28
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
746347392A
GA
Enumeration date
02/07/2007
Last updated
03/20/2017
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