Organization
PENINSULA REHABILITATION AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLEY K. ROGAN M.ED., PT, ATC (VICE PRESIDENT)
(302) 645-9797
Entity
Organization
Contact information
Practice address
18958 COASTAL HWY STE A, REHOBOTH BEACH, DE 19971-6196
(302) 645-9797
(302) 645-0411
Mailing address
18958 COASTAL HWY STE A, REHOBOTH BEACH, DE 19971-6196
(302) 645-9797
(302) 645-0411
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0000810
DE
225100000X
Physical Therapist
J1-0001325
DE
225100000X
Physical Therapist
J1-0002288
DE
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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