Provider Demographics
NPI:1508048174
Name:SPECIALIZED WORKCOMP SERVICES, LLC
Entity Type:Organization
Organization Name:SPECIALIZED WORKCOMP SERVICES, LLC
Other - Org Name:SWS REHAB
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-907-4797
Mailing Address - Street 1:4215 SOUTHPOINT BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-0976
Mailing Address - Country:US
Mailing Address - Phone:866-907-4797
Mailing Address - Fax:866-908-4797
Practice Address - Street 1:4215 SOUTHPOINT BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0976
Practice Address - Country:US
Practice Address - Phone:866-907-4797
Practice Address - Fax:866-908-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy