Powerback Rehabilitation LLC
Physical Therapist in O Fallon, IL. Organization (NPI-2).
NPI number1982018362
StatusActive
Last updated in NPPESFeb 21, 2025
Details
- NPI
- 1982018362
- Entity type
- Organization (NPI-2)
- Legal business name
- Powerback Rehabilitation LLC
- Organization subpart
- No
- Enumeration date
- Jun 13, 2014
- Certification date
- Feb 21, 2025
- Last updated
- Feb 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Other names
- Powerback Rehabilitation (Doing Business As)
Practice location
1022 E Wesley DrO Fallon, IL 62269-6107
Phone 618-607-5081
Mailing address
101 E State StC/O Business Development
Kennett Square, PA 19348-3109
Phone 800-728-8808
Authorized official
Ian Oppel
Coo
9802547007
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All 29 Physical Therapist providers in O Fallon · All 1,289 providers in O Fallon
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