Provider Demographics
NPI:1306246541
Name:UNITED REHAB ASSOCIATES OF CLINTON, LLC
Entity type:Organization
Organization Name:UNITED REHAB ASSOCIATES OF CLINTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:601-382-3699
Mailing Address - Street 1:590 SPRINGRIDGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5641
Mailing Address - Country:US
Mailing Address - Phone:601-473-2317
Mailing Address - Fax:601-473-2327
Practice Address - Street 1:590 SPRINGRIDGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5641
Practice Address - Country:US
Practice Address - Phone:601-473-2317
Practice Address - Fax:601-473-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy