Organization
INDEPENDENCE REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAN XI M.D. (OWNER)
(717) 875-8909
Entity
Organization
Contact information
Practice address
1237 W SHERMAN AVE, VINELAND, NJ 08360-6920
(717) 875-8909
(818) 671-2225
Mailing address
1425 PICKET DR, LANCASTER, PA 17601-4583
(717) 875-8909
(818) 671-2225
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD431974
PA
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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