Organization
LAVIE REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTEN JAMES JACKSON OTR/L (OCCUPATIONAL THERAPIST)
(850) 832-8071
Entity
Organization
Contact information
Practice address
636 TYNDALL PKWY, PANAMA CITY, FL 32404
(850) 871-6363
Mailing address
10210 HIGHLAND MANOR DR, STE 270, TAMPA, FL 33610-9151
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OT11464
FL
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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