Healthcare Provider Details

I. General information

NPI: 1609343094
Provider Name (Legal Business Name): I AM REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 SCOTT AVE
FORT SCOTT KS
66701-2768
US

IV. Provider business mailing address

PO BOX 566
FORT SCOTT KS
66701-0566
US

V. Phone/Fax

Practice location:
  • Phone: 620-223-7073
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: HUGO DAHLSTROM
Title or Position: OWNER
Credential:
Phone: 620-223-7073