Rebound Physical Therapy

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT-AT-707950 Issued in OR

Legal business name

REBOUND PHYSICAL THERAPY

Practice address

200 NE Mother Joseph PL
Suite G100
Vancouver, WA 98664-3299

Phone

(360) 514-2048

Fax

(360) 514-3155

NPI assigned

Apr 6, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brady W Corse, A.T.C

Title

Athletic Trainer

Phone

(360) 514-2048

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720040397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11610 NW 27TH COURT",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE G100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-514-2048",
            "fax_number": "360-514-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOUND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORSE",
        "authorized_official_first_name": "BRADY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "360-514-2048",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "A.T.C"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT-AT-707950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.