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Organization

RWW OUTPATIENT REHAB SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY A PANK (PARALEGAL)
(502) 394-2100
Entity
Organization

Contact information

Practice address
1190 E MISSOURI AVE STE 100, PHOENIX, AZ 85014-2719
(602) 393-0520
(602) 393-0523
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(502) 394-2100

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
225100000X
Physical Therapist
Primary
225200000X
Physical Therapy Assistant
225X00000X
Occupational Therapist

Other

Enumeration date
06/21/2018
Last updated
06/21/2018
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