Provider Demographics
NPI:1982720108
Name:MUSCULOSKELETAL REHAB, INC.
Entity Type:Organization
Organization Name:MUSCULOSKELETAL REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAMAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:352-357-6575
Mailing Address - Street 1:4070 CACTUS LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-5200
Mailing Address - Country:US
Mailing Address - Phone:352-455-0028
Mailing Address - Fax:
Practice Address - Street 1:2105 PREVATT ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6131
Practice Address - Country:US
Practice Address - Phone:352-357-6575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty