Organization
SOUTHERN REHAB WORKS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE MARIE LAMPORT MOT,OTR/L (OWNER)
(618) 534-5670
Entity
Organization
Contact information
Practice address
580 HOOT OWL LN, WOLF LAKE, IL 62998-1137
(618) 534-5670
Mailing address
PO BOX 1652, MURPHYSBORO, IL 62966-5152
(618) 534-5670
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
056.008780
IL
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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