MEDICARE: PROHAB REHABILITATION SERVICES, INC.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871596775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROHAB REHABILITATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	1000 REGENCY CT
Second Line	:	STE 105
City	:	TOLEDO
State	:	OH
Zip	:	43623-3074
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 REGENCY CT
Second Line	:	STE 105
City	:	TOLEDO
State	:	OH
Zip	:	43623-3074
Country	:	US
Telephone Number	:	419-885-2322
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DAMIAN CAIRNS
Credential	:
Telephone Number	:	419-885-2322

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/22/2020

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