Active Rehab LLC

Organization Active NPI Occupational Therapist · Jefferson City, MO

NPI 1477540102 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1477540102
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Therapist 225X00000X
License
000324 (MO)
Legal business name
ACTIVE REHAB LLC
Practice address
2713A Industrial Dr
Jefferson City, MO 65109
Phone
(573) 634-7541
Fax
(573) 634-7543
NPI assigned
Sep 27, 2005
Organization subpart
No

Authorized official

Name
Cynthia Louise Gallatin, OTR
Title
Occupational Therapist Member
Phone
(573) 634-7541

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

319 Pioneer Trail Dr
Jefferson City, MO 65109
Phone (573) 636-5300

901 W High St
Jefferson Cty, MO 65109
Phone (573) 634-7541

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225X00000X 000324 MO Yes

Addresses

Primary practice location

2713A Industrial Dr
Jefferson City, MO 65109

Mailing address

2713A Industrial Dr
Jefferson City, MO 65109
Phone (573) 634-7541

Other identifiers

IdentifierTypeStateIssuer
2062395OtherMOFIRST HEALTH
611850OtherMOHEALTH LINK

Other providers in Jefferson City, MO

All providers in Jefferson City, MO · Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.