Healthcare Provider Details

I. General information

NPI: 1124276217
Provider Name (Legal Business Name): QUALITY REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3604 GALLEY RD STE 200
COLORADO SPRINGS CO
80909-4302
US

IV. Provider business mailing address

3604 GALLEY RD STE 200
COLORADO SPRINGS CO
80909-4302
US

V. Phone/Fax

Practice location:
  • Phone: 719-550-4613
  • Fax: 719-375-8426
Mailing address:
  • Phone: 719-550-4613
  • Fax: 719-375-8426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JASON YISU PARK
Title or Position: CEO/ OWNER
Credential: PT, DPT
Phone: 719-550-4613