Provider Demographics
NPI:1205865474
Name:BRADLEY REHABILITATION CENTER, INC.
Entity Type:Organization
Organization Name:BRADLEY REHABILITATION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTEIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LABOY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:423-479-7800
Mailing Address - Street 1:PO BOX 4290
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-4290
Mailing Address - Country:US
Mailing Address - Phone:423-479-7800
Mailing Address - Fax:423-479-2849
Practice Address - Street 1:65 MOUSE CREEK RD NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-4840
Practice Address - Country:US
Practice Address - Phone:423-479-7800
Practice Address - Fax:423-479-2849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty