MEDICARE: REMOVE REHAB AND PERFORMANCE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1417843814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMOVE REHAB AND PERFORMANCE LLC

Provider Business Mailing Address
First Line	:	2218 BORBECK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3724
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2218 BORBECK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3724
Country	:	US
Telephone Number	:	267-239-3011
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATY VIEIRA
Credential	:	DPT
Telephone Number	:	267-239-3011

Provider Enumeration Date	:	06/13/2025
Last Update Date	:	06/13/2025

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