Organization
SOUTHEAST REHABILITATION, LLC
Active
Other names
Poplar Bluff Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
KYLEE ELLSWORTH (OFFICE MANAGER)
(573) 712-2280
Entity
Organization
Contact information
Practice address
3999 HWY PP, SUITE 2, POPLAR BLUFF, MO 63901
(573) 712-2280
(573) 778-9589
Mailing address
PO BOX 3, POPLAR BLUFF, MO 63902-0003
(573) 712-2280
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/26/2007
Last updated
07/17/2015
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