Pro Active Advantage, Llc in Burley - Rehabilitation
Pro Active Advantage, Llc - NPI 1124148176
Pro Active Advantage, Llc is a Rehabilitation in Burley, Idaho. Pro Active Advantage, Llc practices all healthcare services and medical treatments related to Rehabilitation. The NPI Number for Pro Active Advantage, Llc is 1124148176. The last update date is 2021-09-15.
Pro Active Advantage, Llc's current location address is 1369 E 16th St Ste 2, Burley, Idaho. You can contact this provider via phone number 2088783423 and fax number 2088783424. The mailing address for Pro Active Advantage, Llc is 1369 E 16th St Ste 2, Burley, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pro Active Advantage, Llc |
|---|---|
| Address | 1369 E 16th St Ste 2, Burley, Idaho |
| Phone Number | 2088783423 |
| Fax Number | 2088783424 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Knight J Frank |
| Telephone Number | 2089345880 |
NPI Number Detail
| NPI Number | 1124148176 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2021-09-15 |
Provider Mailing Address Detail
| Address | 1369 E 16th St Ste 2 |
|---|---|
| City | Burley |
| State | Idaho (ID) |
| Post Code | 833182008 |
| Phone Number | 2088783423 |
| Fax Number | 2088783424 |
Provider's Primary Taxonomy Detail
| Speciality | Rehabilitation |
|---|---|
| Taxonomy | 103Tr0400X |
|
Definition: A psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illness. Rehabilitation psychologists, often within teams, assess and treat cognitive, emotional, and fu |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8073698 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Pro Active Advantage, Llc by the Centers for Medicare & Medicaid Services?
The Pro Active Advantage, Llc has been issued the NPI (National Provider Identifier) 1124148176, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Pro Active Advantage, Llc is physically located?
The Pro Active Advantage, Llc is physically situated at the following address: 1369 E 16Th St Ste 2, Burley, ID, 833182008.
What is Pro Active Advantage, Llc's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Pro Active Advantage, Llc is Rehabilitation, and the taxonomy classification code that categorizes this area of expertise is 103Tr0400X.
When was the Pro Active Advantage, Llc's 1124148176 issued?
The Pro Active Advantage, Llc's 1124148176 was issued on 2007-03-30.
When was the information regarding Pro Active Advantage, Llc most recently updated?
The details pertaining to the Pro Active Advantage, Llc, including its address, specialty, and other relevant information, were last refreshed on 2021-09-15.
NPI Number: 1972505162
Address: 1237 Salem Gate Drive, Conyers, GA