NPI 1083117436

Powerback Rehabilitation LLC

Organisation Rehabilitation Clinic/Center Gainesville, VA

Practice location

Address: 13650 Heathcote Blvd, Gainesville, VA 20155-3344
Phone: (571) 486-1095
Mailing address: 101 E State St, Kennett Square, PA 19348-3109

Authorised official

Name: Carl Anthony Shrom
Title: Ceo
Phone: (215) 896-0422

Registered specialties

Rehabilitation Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QR0400X

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Registry record

NPI: 1083117436
Entity type: Organization
NPI issued: 13 Mar 2018
Record last updated: 2 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.