Prorehab PC
Organization Active NPI Physical Therapist · Eldon, MO
NPI 1972148179 · NPPES record last updated Nov 12, 2019
Key facts
- NPI
- 1972148179
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- PROREHAB PC
- Practice address
- 301 S Maple St
Eldon, MO 65026-1854 - Phone
- (573) 375-5944
- NPI assigned
- Nov 12, 2019
- Organization subpart
- No
Authorized official
- Name
- Juana Granados
- Title
- Credentialing Manager
- Phone
- (630) 575-1980
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Prorehab PC
Locations
301 S Maple St
Eldon, MO 65026
Phone (573) 375-5944
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
301 S Maple St
Eldon, MO 65026-1854
Mailing address
600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200
Other names
- ATHLETICO PHYSICAL THERAPY
Other providers in Eldon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.