Provider Demographics
NPI:1841461522
Name:REHABILITATION ASSOCIATES, LLC
Entity type:Organization
Organization Name:REHABILITATION ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KARA
Authorized Official - Last Name:EATON-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-264-8972
Mailing Address - Street 1:PO BOX 90700
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-0700
Mailing Address - Country:US
Mailing Address - Phone:505-994-4696
Mailing Address - Fax:
Practice Address - Street 1:7000 JEFFERSON STREET, NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87199
Practice Address - Country:US
Practice Address - Phone:505-344-9478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-0062208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty