Provider Demographics
NPI:1699851881
Name:REHABILITATION SERVICES OF ST CROIX
Entity Type:Organization
Organization Name:REHABILITATION SERVICES OF ST CROIX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING PARTNER PHYSICAL THERAPIS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:724-388-0866
Mailing Address - Street 1:PO BOX 5100
Mailing Address - Street 2:SUNNY ISLE
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-5100
Mailing Address - Country:US
Mailing Address - Phone:340-772-9557
Mailing Address - Fax:340-772-9558
Practice Address - Street 1:SUNNY ISLE PROFESSIONAL BLDG
Practice Address - Street 2:SUITE 6F
Practice Address - City:ST CROIX
Practice Address - State:VI
Practice Address - Zip Code:00820-5100
Practice Address - Country:US
Practice Address - Phone:340-772-9557
Practice Address - Fax:340-772-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI78225100000X
MD04637225X00000X
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI5-6728Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER