Organization
PHOENIX REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REX A. PAGGEOT (CFO)
(727) 709-7701
Entity
Organization
Contact information
Practice address
1600 SCOTTSVILLE RD, SUITE 101, BOWLING GREEN, KY 42104-3217
(207) 781-0028
Mailing address
136 SAINT MATTHEWS AVE, SUITE 300, LOUISVILLE, KY 40207-3191
(502) 897-1700
(502) 897-1798
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
101011
KY
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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