Organization
PROACTIVE REHABILITATION & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL EDUARDO SALAZAR II MHS, OTR/L (CEO & OWNER)
(706) 829-6706
Entity
Organization
Contact information
Practice address
2103 REEDALE AVE, AUGUSTA, GA 30906-3430
(706) 814-6887
Mailing address
2320 NEAL ST, AUGUSTA, GA 30906-3082
(706) 829-6706
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
225XE0001X
Environmental Modification Occupational Therapist
—
—
225XE1200X
Ergonomics Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/03/2020
Last updated
10/12/2020
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