Organization
PREMERE REHAB LLC
Active
Other names
Henderson
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA CANTRELL (DIRECTOR OF OUTPATIENT SERVICES)
(360) 901-8111
Entity
Organization
Contact information
Practice address
1050 E LAKE MEAD PKWY, HENDERSON, NV 89015-3200
(702) 564-1771
Mailing address
1050 E LAKE MEAD PKWY, HENDERSON, NV 89015-3200
(702) 564-1771
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EW384A
PTAN
AZ
Enumeration date
02/15/2011
Last updated
02/20/2012
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