Organization
PROFESSIONAL REHABILITATION HOSPITAL LLC
Active
Parent organization
PROFESSIONAL REHABILITATION HOSPITAL, LLC
Other names
Riverbridge Pulmonary Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROFESSIONAL REHABILITATION HOSPITAL, LLC
Authorized official
SONJA SHARP WATKINS (CFO)
(601) 824-9010
Entity
Organization
Contact information
Practice address
107 FRONT ST, VIDALIA, LA 71373-2836
(318) 336-6500
Mailing address
209 FRONT ST, VIDALIA, LA 71373-2837
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/21/2023
Last updated
08/18/2023
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