Provider Demographics
NPI:1518995919
Name:STRATTON REHABILITATION CLINIC INC
Entity Type:Organization
Organization Name:STRATTON REHABILITATION CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIK
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:210-828-7557
Mailing Address - Street 1:414 W SUNSET RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1756
Mailing Address - Country:US
Mailing Address - Phone:210-828-7557
Mailing Address - Fax:210-828-7756
Practice Address - Street 1:414 W SUNSET RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1756
Practice Address - Country:US
Practice Address - Phone:210-828-7557
Practice Address - Fax:210-828-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6375700012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00005SMedicare ID - Type Unspecified