Provider Demographics
NPI:1336305226
Name:INJURY REHAB SPECIALISTS
Entity Type:Organization
Organization Name:INJURY REHAB SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-319-2223
Mailing Address - Street 1:3611 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-5757
Mailing Address - Country:US
Mailing Address - Phone:813-319-2223
Mailing Address - Fax:813-319-2227
Practice Address - Street 1:3611 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-5757
Practice Address - Country:US
Practice Address - Phone:813-319-2223
Practice Address - Fax:813-319-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8024111NR0400X
FLAP2551171100000X
FLME9182208D00000X
FLMA15529225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty