Provider Demographics
NPI:1780919274
Name:SOUTHERN VALLEY REHAB INC.
Entity type:Organization
Organization Name:SOUTHERN VALLEY REHAB INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:STEPP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:479-209-3616
Mailing Address - Street 1:14244 WATALULA RD
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-9269
Mailing Address - Country:US
Mailing Address - Phone:479-209-3616
Mailing Address - Fax:479-667-2706
Practice Address - Street 1:14244 WATALULA RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-9269
Practice Address - Country:US
Practice Address - Phone:479-209-3616
Practice Address - Fax:479-667-2706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty