Jackson Preferred Rehab LLC

NPI #1720265739 in Homer, Michigan

Provider Information

NPI Number: 1720265739
Entity Type: Organization
Organization Name: Jackson Preferred Rehab LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jan 22, 2008
Last Updated: Feb 2, 2009

Practice Location

Address: 119 W MAIN ST
City: Homer
State: Michigan
ZIP Code: 49245-1023
Phone: (866) 568-3100

Authorized Official

Name: KARTHYAYANI KUNCHAPPA, PT
Title: CEO
Phone: (866) 568-3100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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