Provider Demographics
NPI:1174828610
Name:BRIDGE REHABILITATION THERAPIES, INC.
Entity Type:Organization
Organization Name:BRIDGE REHABILITATION THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVADNEY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WALKER-AVOINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-747-5847
Mailing Address - Street 1:714 MANATEE AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1242
Mailing Address - Country:US
Mailing Address - Phone:941-747-5847
Mailing Address - Fax:941-747-4865
Practice Address - Street 1:714 MANATEE AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1242
Practice Address - Country:US
Practice Address - Phone:941-747-5847
Practice Address - Fax:941-747-4865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty