Organization
GENSIS REHAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE CALLAWAY JR. (PHYSICAL THERAPIST ASSISTANT)
(863) 272-0541
Entity
Organization
Contact information
Practice address
1010 CARPENTERS WAY, LAKELAND, FL 33809-3926
(863) 940-4711
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA 24657
FL
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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