Provider Demographics
NPI:1639412836
Name:CHART REHABILITATION
Entity Type:Organization
Organization Name:CHART REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTHERWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-358-0700
Mailing Address - Street 1:1305 AIRPORT FWY
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6605
Mailing Address - Country:US
Mailing Address - Phone:817-358-0700
Mailing Address - Fax:817-358-0703
Practice Address - Street 1:1305 AIRPORT FWY
Practice Address - Street 2:SUITE 402
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6605
Practice Address - Country:US
Practice Address - Phone:817-358-0700
Practice Address - Fax:817-358-0703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FCA ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-05
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy